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Clinical characteristics and management of benign transient non-organic ileus of neonates: a single-center experience.
[hirschsprung disease]
The
term
benign
transient
non-organic
ileus
of
neonates
(
BTNIN
)
is
applied
to
neonates
who
present
symptoms
and
plain
radiographic
findings
of
Hirschsprung
's
disease
,
but
do
not
have
aganglionic
bowel
and
are
managed
well
by
conservative
treatment
.
It
can
often
be
difficult
to
diagnose
BTNIN
because
its
initial
symptoms
are
similar
to
those
of
Hirschsprung
's
disease
.
The
aim
of
this
study
is
to
evaluate
the
clinical
characteristics
and
proper
treatment
of
BTNIN
.
A
retrospective
review
was
made
on
the
clinical
data
of
19
neonates
who
were
treated
for
BTNIN
between
January
2008
and
December
2011
at
a
single
facility
.
Abdominal
distension
occurred
in
every
patient
(
19
/
19
)
.
Other
common
symptoms
included
emesis
(
5
/
19
)
,
explosive
defecation
(
5
/
19
)
,
and
constipation
(
4
/
19
)
.
The
vast
majority
of
patients
(
15
/
19
)
experienced
the
onset
of
symptoms
between
2
and
4
weeks
of
age
.
Radiograph
findings
from
all
of
the
patients
were
similar
to
Hirschsprung
's
disease
.
A
barium
study
showed
a
transition
zone
in
33
.
4
%
(
6
/
18
)
of
the
patients
.
However
,
rectal
biopsy
revealed
ganglion
cells
in
the
distal
rectum
in
88
.
2
%
(
15
/
17
)
of
the
patients
,
and
anorectal
manometry
showed
a
normal
rectoanal
inhibitory
reflex
in
90
%
(
9
/
10
)
.
All
patients
responded
well
to
conservative
treatment
.
Symptoms
disappeared
at
the
mean
age
of
4
.
9
±
1
.
0
months
,
and
the
abdominal
radiographs
normalized
.
BTNIN
had
an
excellent
outcome
with
conservative
treatment
,
and
must
be
differentiated
from
Hirschsprung
's
disease
.
A
rectal
biopsy
and
anorectal
manometry
were
useful
diagnostic
tools
in
the
differential
diagnosis
.
