HD is treated with surgery. The surgery is called a pull-through operation. There are three common ways to do a pull-through, and they are called the Swenson, the Soave, and the Duhamel procedures. Each is done a little differently, but all involve taking out the part of the intestine that doesn't work and connecting the healthy part that's left to the anus. After pull-through surgery, the child has a working intestine.
Before surgery: The diseased section is the part of the intestine that doesn't work.
Step 1: The doctor removes the diseased section.
Step 2: The healthy section is attached to the rectum or anus.
Colostomy and Ileostomy
Often, the pull-through can be done right after the diagnosis. However, children who have been very sick may first need surgery called an ostomy. This surgery helps the child get healthy before having the pull-through. Some doctors do an ostomy in every child before doing the pull-through.
In an ostomy, the doctor takes out the diseased part of the intestine. Then the doctor cuts a small hole in the baby's abdomen. The hole is called a stoma. The doctor connects the top part of the intestine to the stoma. Stool leaves the body through the stoma while the bottom part of the intestine heals. Stool goes into a bag attached to the skin around the stoma. You will need to empty this bag several times a day.
Step 1: The doctor takes out most of the diseased part of the intestine.
Step 2: The doctor attaches the healthy part of the intestine to the stoma (a hole in the abdomen)
If the doctor removes the entire large intestine and connects the small intestine to the stoma, the surgery is called an ileostomy. If the doctor leaves part of the large intestine and connects that to the stoma, the surgery is called a colostomy.
Later, the doctor will do the pull-through. The doctor disconnects the intestine from the stoma and attaches it just above the anus. The stoma isn't needed any more, so the doctor either sews it up during surgery or waits about 6 weeks to make sure that the pull-through worked.
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