THE SYMPTOM OF ANXIETY IS CONSTIPATION AS A MANIFESTATION OF HIRSCHSPRUNG'S DISEASE IN A CHILD

Functional digestive disorders in the form of constipation in infants are one of the most common reasons to contact a district pediatrician. The specialist must have theoretical knowledge and practical skills, as well as alertness, to carry out differential diagnosis of the functional and organic genesis of the disease. The main cause of functional digestive disorders in children in the first months of life is associated with the immaturity of the gastrointestinal tract. Clinical observation demonstrates a case of Hirschsprung's disease in a child in the second month of life with a feature of clinical manifestations. At birth, there was a delay in the discharge of meconium, a slight bloating. After the enema, the symptoms stopped, and the child was discharged home. Later, due to an increase in the volume of nutrition and the transfer to artificial feeding, anxiety symptoms appeared in the form of constipation, which required regular cleansing enemas, bloating, delays in gas discharge, and insufficient weight gain in the first month of life. Attention was drawn to the change in the nature, color, and smell of the stool, which is not the norm for children of the first month of life. The general condition of the child gradually worsened due to the addition of hyperthermic and intoxication syndrome, the cause of which was the development of a life-threatening condition – Hirschsprung-associated enterocolitis (HAEC). Hirschsprung's disease of the rectosigmoid intestine was diagnosed by irrigoscopy. Surgical treatment was delayed until the condition stabilized for associated enterocolitis. The clinical signs of associated enterocolitis were compensated in dynamics against the background of antibacterial therapy, infusion therapy and hemotransfusion. After stabilization of the child's condition, a transanal resection of the rectum and sigmoid colon with the agangliosis zone was performed. The course of the postoperative period is without complications. Hypogangliosis was confirmed by histological examination of the colon fragment.