SURGICAL NURSING TWO PRESENTATION FOR ALL BSC STUDENT

Presentations on Surgical nursing Two for all BSC nursing Students

1. KAAF UNIVERSITY COLLEGE DEPARTMENT OF GENERAL NURSING GROUP FOUR SURGICAL NURSING II PRESENTATION

2. TOPIC HIRSCHSPRUNG DISEASE

3. PRESENTATION OUTLINE DEFINITIONS OF HIRSCHSPRUNG DISEASE INCIDENCE OF HIRSCHSPRUNG DISEASE AETIOLOGY OF HIRSCHSPRUNG DISEASE RISK FACTORS OF HIRSCHSPRUNG DISEASE CLINICAL MANIFESTATION OF HIRSCHSPRUNG DISEASE DIAGNOSIS OF HIRSCHSPRUNG DISEASE MANAGEMENT OF HIRSCHSPRUNG DISEASE COMPLICATIONS OF HIRSCHSPRUNG DISEASE REERENCES

4. HIRSCHSPRUNG DISEASE A condition of the large intestine(colon) that causes difficulty in passing stool. Hirschsprung disease involves missing nerve cells in the muscles of part, or all of the large intestine (colon),that is present at birth, it causes difficulty in passing stool.

5. INCIDENCE Hirschsprung disease is congenital conditions that typically affect children, but it can also occur in adults. However, the presentation and diagnosis of Hirschprung in adults are different from those in children. It occurs five times more often in Males than in Females.

6. AETIOLOGY The exact cause is unknown, The etiology of Hirschsprung disease involves a combination of genetic and environmental factors Genetic Factors 1.Familial cases: 10-20% of cases have a family history . 2 . Chromosomal abnormalities: Associated with Hirschsprung disease, including trisomy 21.

7. CON”T AETIOLOGY Environmental Factors : Maternal diabetes: Increased risk of Hirschsprung disease Maternal age: Advanced maternal age may contribute to increased risk .

8. RISK FACTORS 1.Family history : Having a first-degree relative with Hirschsprung disease increases the risk . 2 . Chromosomal abnormalities: Trisomy 21 (Down syndrome) and other chromosomal abnormalities increase the risk . 3 . Maternal diabetes: Maternal diabetes during pregnancy increases the risk . 4 . Advanced maternal age: Women over 35 years old have a higher risk .

9. CON’T OF RISK FACTORS 5. Male sex: Hirschsprung disease is more common in males than females. 6. Prematurity: Premature birth increases the risk. 7. Low birth weight: Low birth weight increases the risk. 8. Other congenital abnormalities: Presence of other congenital anomalies, such as heart defects or cleft palate

10. CLINICAL MANIFESTATION Neonatal period: - Failure to pass meconium within 48 hours - Bilious vomiting - Abdominal distension - Constipation or intestinal obstruction

11. CON’T OF CLINICAL MANIFESTATIONS Infancy: - Chronic constipation - Abdominal pain or discomfort - Vomiting -Diarrhea (in some cases) - Poor weight gain

12. Childhood: - Chronic constipation - Encopresis (soiling) - Abdominal pain or discomfort - Nausea and vomiting - Poor appetite

13. DIAGNOSIS Clinical evaluation - Medical history - Physical examination - Rectal examination Imaging studies - Abdominal X-ray: to assess bowel obstruction and dilatation -Ultrasound : to assess bowel wall thickness and motility Confirmatory tests : -Rectal biopsy: to examine for ganglion cells (gold standard) - Anorectal manometry: to assess anal sphincter function - Rectal suction biopsy: a less invasive alternative to rectal biopsy

14. MANAGEMENT Surgical treatment Pull-through surgery to remove the ganglionic segment and restore intestinal continuity. Minimally invasive techniques (e.g., laparoscopic or robotic-assisted surgery ) Preoperative management : Bowel preparation to reduce bacterial load and prevent enterocolitis. Antibiotics and supportive care to manage enterocolitis or other complications.

15. CON’T OF MANAGEMENT Postoperative management : - Pain management and wound care. - Monitoring for complications (e.g., infection, bowel obstruction). - Gradual introduction of oral feeding .

16. CON’T Supportive care : - Bowel management programs to address constipation or incontinence. - Dietary modifications (e.g., high-fiber diet, avoidance of trigger foods). - Psychological support for patients and families .

17. COMPLICATIONS . Enterocolitis : - Inflammation of the intestine and colon - Can occur before or after surgery - May lead to sepsis, perforation, or death . Intestinal obstruction : - Bowel blockage due to narrowing or twisting - May require emergency surgery . Perforation : - Hole in the intestine, leading to peritonitis (infection of the abdominal cavity ) Malnutrition : - Impaired nutrient absorption due to bowel dysfunction - May lead to growth failure, weight loss, or vitamin deficiencies Constipation : - Chronic constipation due to residual aganglionosis or bowel dysfunction

18. A PICTORIAL VIEW OF HIRSCHSPRUNG’S DISEASE

19. REFERENCES 1. National Institutes of Health (NIH) - Genetic and Rare Diseases Information Center (GARD): Hirschsprung disease 2 . MedlinePlus Medical Encyclopedia - Hirschsprung's disease 3 . Orphanet - Hirschsprung disease 4 . American Academy of Pediatrics (AAP) - Hirschsprung Disease5. National Organization for Rare Disorders (NORD) - Hirschsprung Disease

20. END OF THE PRESENTATION THANK YOU

21. GROUP MEMBERS NAMES INDEX NUMBERS OSEI HAYFORD 43325123 FATCHU BEN LOUIS 43334823 OSEI MARGARET 43350923 RITA ESI ARHIN 43319223 FRANCISCA TAKYI 43338223 REBECCA BOAFO APPIAH 43307221 STEPHENY ADWOA NKRUMAH 43309223 CHRISTIANA OPOKU 43315022 ANGELA KONU 43349423 DORIS TETTEH 43324623 SANDRA AGYEKUM 43325923 MAALINYUUR ROSINA 43337923 MARY DENKEY MENSAH 43315122 ADDO CAROLINE LAWRENCIA AUGUSTINA AMPIAW VIVIAN ADDO 43320621 43316621 43350823