319 Slov Pediatr 2018; 25
Rezultati: 	 Med 	 138 	 otroki 	 je 	 bilo 	 61 	 dečkov 	 (44,2	 %) 	 in 	 77	 deklic 	 (55,8 	 %).	 Največ	 otrok 	 je 	 bilo 	 starih 	 5–10	
let. 	 Povprečna 	 starost 	 je 	 bila 	 9,09 	 leta, 	 vrednost 	 standardnega 	 odklona 	 (SD) 	 pa 	 3,543. 	 Kar 	 93	 (67,4 	 %) 	 otrok 	
je 	 bilo 	 primerno 	 prehranjenih	 (skupina 	 0), 	 29	 (21,0 	 %)	 prekomerno	 prehranjenih	 (skupina	 1) 	 in 	 16 	 (1 1,6	 %) 	
debelih 	(skupina	2)	(p	>0,05).
Zaključek:	 Pri 	 otrocih 	 in 	 mladostnikih 	 s	 PME 	 nismo 	 ugotovili 	 statistično 	 značilno 	 pogostejšega 	 pojavljanja	
prekomerne 	 prehranjenosti 	 in 	 debelosti. 	 V erjetno 	 bi	 bil	 delež 	 višji 	 pri 	 večjem 	 vzorcu 	 otrok 	 in	 ob	 vključitvi 	
otrok 	 s 	 pridruženimi 	 dnevnimi 	 mikcijskimi 	 težavami 	 (z 	 nemonosimptomatsko	 enurezo). 	 Etiološka 	 pove -
zava 	 med 	 enurezo 	 in 	 debelostjo 	 ni 	 znana,	 pogosta 	 pa 	 je 	 sopojavnost	 z 	 drugimi	 boleznimi. 	 Zaradi	 možnih 	
resnih 	 neugodnih 	 fizioloških 	 in 	 psiholoških 	 posledic	 ju 	 moramo	 aktivno 	 iskati 	 in 	 zdraviti 	 že 	 v 	 otroškem 	
obdobju.
Ključne besede: enureza, prekomerna prehranjenost, debelost, motnje mikcije.
HIRSCHPRUNG’ S DISEASE – A CASE REPORT
V . 	 Ivančević, 	N. 	 T adić
Medical Center Budva, Budva, Montenegro
ABSTRACT
Case report: 	 W e	 present 	 a 	 male 	 infant, 	 aged	 three 	 years 	 and 	 two	 months, 	 born	 vaginaly .	 In 	 the 	 second 	 day	
of 	 life 	 he 	 started 	 to 	 vomit 	 bilious 	 contents, 	 became 	 febrile	 and 	 was 	 not 	 passing 	 stool. 	 After	 consulting 	 with 	
a 	 pediatric 	 sur geon,	 an 	 abdominal 	 X-ray 	 was 	 performed 	 along 	 with 	 an 	 enema, 	 which 	 resulted 	 in 	 meagre 	
stool. 	 An 	 irigography	 was 	 performed 	 due 	 to	 worsening 	 of 	 the	 child’ s	 condition, 	 where	 a	 rupture	 of 	 the 	 colon	
was 	 diagnosed. 	 Due 	 to 	 this 	 diagnosis 	 an 	 emer gency 	 sur gery 	 had 	 to 	 be 	 performed: 	 Laparathomia 	 supraum -
bilicalis 	 transversalis; 	 Resectio 	 colonis 	 part 	 pp	 rupturae	 N 	 II;	 Colostomia 	 sec	 Penna. 	 The 	 resected	 biopsy 	
specimen 	 was 	 given	 for 	 pathohistological 	 analysis, 	 which	 showed	 an 	 aganglionic	 colon 	 segment. 	 After	 this	
discovery , 	 an 	 ileostomy 	 in 	 the 	 terminal 	 part 	 of 	 the 	 ileum 	 (5 	 cm 	 from 	 the 	 ileocaecal 	 valve) 	 was 	 performed. 	
The 	 infant 	 had 	 irregular 	 stools 	 and 	 poor 	 weight 	 and 	 height 	 gain. 	 20 	 days 	 after 	 the 	 sur gical	 procedure, 	 the 	
infant 	 was 	 transfered 	 to 	 UDK 	 Belgrade 	 for 	 further 	 treatment 	 as 	 the 	 parameters 	 of 	 infection 	 increased. 	 The 	
following 	 medical 	 procedure 	 was 	 performed: 	 Relaparatomio 	 transfersalis 	 supraumbilicalis; 	 Adhesiolysis. 	
and 	 after 	 an 	 enterotomy 	 was 	 performed, 	 a 	 membrane 	 was 	 discovered 	 at 	 the 	 proximate 	 jejunum 	 which 	 was 	
obstructing 	 the 	 lumen, 	 and 	 was 	 therefore 	 removed. 	 At	 the	 age 	 of 	 2.5 	 a 	 planned 	 laparotomy 	 was 	 performed	
due 	 to 	 the 	 gradual 	 closing 	 of 	 the 	 ileostoma. 	 The 	 following 	 procedures 	 were 	 done: 	 Adhesiolysis, 	 colecto -
miasubtotalis, 	 ileostomia 	 terminalis 	 ileo-ano 	 TT 	 anastomosis.	 In 	 two	 months 	 time, 	 the 	 closing 	 of	 the	 ileos -
tome 	is 	planned 	which 	would	conclude 	the 	treatment.
Conclusion: 	 A 	 rare 	 case 	 of 	 agangliosis 	 totalis 	 was	 shown 	 – 	 Hirschprung’ 	 s 	 disease 	 combined	 with 	 a	 con-
genital 	membrane 	 on	the 	jejunum.
Key words: megacolon, ileus, infant.