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Mejia M, Royero Arias M, Pimiento Figueroa J, Romero Espitia W. Megacystis- Microcolon-Intestinal Hypoperistalsis Syndrome: A Case Report of an Uncommon Condition. Cureus 2024; 16:e54255. [PMID: 38496087 PMCID: PMC10944333 DOI: 10.7759/cureus.54255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2024] [Indexed: 03/19/2024] Open
Abstract
The megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS), also known as Berdon syndrome, is a rare congenital condition that falls within the spectrum of visceral myopathies. It is characterized by the presence of megacystis, microcolon, and hypoperistalsis, which are secondary to gastrointestinal and urinary system dysmotility. It is frequently associated with other alterations in the gastrointestinal and genitourinary tracts. Although it is possible to make the diagnosis in the prenatal period, most cases are diagnosed after birth through genetic and imaging studies. Advances in treatment have led to a progressive increase in survival rates. We present the case of a newborn with congenital alterations described prenatally and with imaging findings characteristic of the syndrome.
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Affiliation(s)
- Marcia Mejia
- Radiology, Universidad de Antioquia, Medellín, COL
| | - Mónica Royero Arias
- Pediatric Radiology, Hospital Universitario San Vicente Fundación, Medellín, COL
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Nandan R, Pandey V, Suresh G, Singh RK, Kachhap S. Congenital Segmental Dilatation of Ascending Colon with Distal Microcolon: A Diagnostic Dilemma. J Indian Assoc Pediatr Surg 2023; 28:529-531. [PMID: 38173636 PMCID: PMC10760621 DOI: 10.4103/jiaps.jiaps_132_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 07/26/2023] [Accepted: 08/07/2023] [Indexed: 01/05/2024] Open
Abstract
A 5-day-old male presented with bilious vomiting, a grossly distended abdomen, and passage of a small amount of stool. The anal opening was at a normal position. X-ray abdomen showed a large bowel loop with a single air-fluid level occupying more than half of the abdominal width. On laparotomy, the ascending colon was dilated to form a pouch-like structure, and the ileum and appendix were opening into it. Colon distal to pouch was present as microcolon. Histopathology of the dilated segment was suggestive of congenital segmental dilatation (CSD). In CSD, the distal bowel is of normal caliber. This is a rare case of CSD of ascending colon with distal microcolon.
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Affiliation(s)
- Ruchira Nandan
- Department of Pediatric Surgery, IMS-Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Vaibhav Pandey
- Department of Pediatric Surgery, IMS-Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Greeshma Suresh
- Department of Pediatric Surgery, IMS-Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Rajat Kumar Singh
- Department of Pediatric Surgery, IMS-Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Seth Kachhap
- Department of Pediatric Surgery, IMS-Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Kalsbeek A, Dhar-Dass R, Hanan A, Al-Haddad E, William I, Alazraki A, Poulik J, McCollum K, Almashad A, Shehata BM. Five New Cases of Megacystis- Microcolon-Intestinal Hypoperistalsis Syndrome (MMIHS), with One Case Showing a Novel Mutation. Fetal Pediatr Pathol 2022; 41:749-758. [PMID: 34383618 DOI: 10.1080/15513815.2021.1964656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS) is a lethal congenital disorder characterized by a large, non-obstructed bladder, microcolon, and lack of proper peristalsis. MATERIALS AND METHODS Five cases of MMIHS were identified, confirmed histologically and were predominantly female (F:M, 4:1). DNA sequencing was also performed. RESULTS Four cases showed mutations in the α3 and β4 nicotinic acetylcholine receptor (ηAChR) subunits (CHRNA3 and CHRNB4, respectively) on chromosome 15q24. The 5th case had a delayed clinical presentation of intussusception at 11 months and showed a novel missense mutation in ATP2B4 on Chromosome 1q32. CONCLUSION The first four patients showed a previously identified mutation. The 5th patient shows a novel mutation in ATP2B4. This novel gene was associated with a less severe presentation and increases success of multiorgan transplant than the other four patients. This highlights how identifying various mutations may impact prognosis and clinical treatment plans for MMIHS patients.
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Affiliation(s)
- Alyssa Kalsbeek
- Department of Pathology, Children's Hospital of Michigan, Detroit, Michigan, USA
| | - Renee Dhar-Dass
- Department of Pathology, Children's Hospital of Michigan, Detroit, Michigan, USA
| | - Abdul Hanan
- Department of Pathology, Children's Hospital of Michigan, Detroit, Michigan, USA
| | - Eman Al-Haddad
- Department of Pathology, Children's Hospital of Michigan, Detroit, Michigan, USA
| | - Iman William
- Department of Pathology, Children's Hospital of Michigan, Detroit, Michigan, USA
| | - Adina Alazraki
- Department of Pathology, Children's Hospital of Michigan, Detroit, Michigan, USA
| | - Janet Poulik
- Department of Pathology, Children's Hospital of Michigan, Detroit, Michigan, USA
| | - Kasey McCollum
- Department of Pathology, Children's Hospital of Michigan, Detroit, Michigan, USA
| | - Aya Almashad
- Department of Pathology, Children's Hospital of Michigan, Detroit, Michigan, USA
| | - Bahig M Shehata
- Department of Pathology, Children's Hospital of Michigan, Detroit, Michigan, USA
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Surd A, Gheban D, Mironescu A, Aldea C, Gocan H. Megacystis- microcolon-intestinal hypoperistalsis syndrome associated with cystic fibrosis and meconium peritonitis in a female neonate 4 days of age - case report and review of the literature. Med Pharm Rep 2020; 93:422-427. [PMID: 33225270 PMCID: PMC7664722 DOI: 10.15386/mpr-1583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 05/07/2020] [Accepted: 05/21/2020] [Indexed: 11/23/2022] Open
Abstract
We present a case of megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS) in a four days old female infant who presented with abdominal distension, bilious vomiting, massive hematuria and feeding intolerance which was first interpreted as Prune Belly Syndrome (PBS), referred to our department after iatrogenic gastric and colonic perforation. Berdon syndrome or MMIHS is a rare congenital anomaly characterized by a massive enlarged bladder, distended abdomen, microcolon, functional obstruction of the gastrointestinal tract, and malrotation.
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Affiliation(s)
- Adrian Surd
- Pediatric Surgery Department, Emergency Children's Hospital, Cluj-Napoca, Romania
| | - Dan Gheban
- Pathology Department, Emergency Children's Hospital, Cluj-Napoca, Romania
| | - Aurel Mironescu
- Pediatric Surgery Department, Children's Hospital, Brasov, Romania
| | - Cornel Aldea
- Pediatric Nephrology Department, Emergency Children's Hospital, Cluj-Napoca, Romania
| | - Horaţiu Gocan
- Pediatric Surgery Department, Emergency Children's Hospital, Cluj-Napoca, Romania
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Yetman AT, Starr LJ. Newly described recessive MYH11 disorder with clinical overlap of Multisystemic smooth muscle dysfunction and Megacystis microcolon hypoperistalsis syndromes. Am J Med Genet A 2019; 176:1011-1014. [PMID: 29575632 DOI: 10.1002/ajmg.a.38647] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 01/29/2018] [Accepted: 01/29/2018] [Indexed: 12/12/2022]
Abstract
We describe a neonatal patient with fixed dilated pupils and pulmonary, bladder, and bowel dysfunction suspicious for the presence of ACTA2 R179 mediated multisystemic smooth muscle dysfunction syndrome. Whole exome sequencing revealed compound heterozygous mutations in MYH11 after ACTA2 specific testing revealed no abnormalities. The child lived until 18 months of age and represents the only reported case of an MYH11 compound heterozygote with widespread smooth muscle dysfunction.
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Affiliation(s)
- Anji T Yetman
- Division of Cardiology, Department of Pediatrics, University of Nebraska Medical Center, Omaha, Nebraska
| | - Lois J Starr
- Division of Medical Genetics, Department of Pediatrics, University of Nebraska Medical Center, Omaha, Nebraska
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Patoulias I, Feidantsis T, Doitsidis C, Mitroudi M, Kalogirou MS, Patoulias D. Early diagnosis and surgical intervention untie the Gordian knot in newborns with colonic atresia: report of two cases and review of the literature. Folia Med Cracov 2019; 59:67-79. [PMID: 31891361 DOI: 10.24425/fmc.2019.131137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Incidence of colonic atresia in living infants ranges from 1:5,000 to 1:60,000 (average 1:20,000). It constitutes 1.8 to 15% of all cases of atresia of the gastrointestinal tract. In 58.56-75% of all cases is right-sided. We aim, through the presentation of two cases of colonic atresia which we encountered and after systematic research of the current literature, at addressing three major issues: diagnostic approach, operative strategy and management of the prognostic parameters of the colonic atresia. The common parameter in these two cases was the early diagnosis, which played a significant role in the uncomplicated postoperative course. The first case was a type I sigmoid atresia. Contrast's escape during contrast enema examination due to accidental rupture of the distal part of the colon led to diagnosis. Side-to-side anastomosis, restoration of the rupture and a central loop sigmoidostomy were urgently performed. The second case was a type III atresia at the level of the ascending colon, which was early diagnosed via pregenital ultrasonography, in which colonic dilation was depicted. Restoration of the intestinal continuity early after birth was performed at a time. In conclusion, we believe that early diagnosis, selection of the appropriate operative strategy and prompt recognition of potential post-operative complications, especially rupture of the anastomosis, contribute to the optimization of the prognosis in patients with colonic atresia.
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Affiliation(s)
- Ioannis Patoulias
- First Department of Pediatric Surgery, Aristotle University of Thessaloniki General Hospital "G. Gennimatas", Thessaloniki, Greece
| | - Thomas Feidantsis
- First Department of Pediatric Surgery, Aristotle University of Thessaloniki General Hospital "G. Gennimatas", Thessaloniki, Greece
| | - Charalampos Doitsidis
- First Department of Pediatric Surgery, Aristotle University of Thessaloniki General Hospital "G. Gennimatas", Thessaloniki, Greece
| | - Magdalini Mitroudi
- First Department of Pediatric Surgery, Aristotle University of Thessaloniki General Hospital "G. Gennimatas", Thessaloniki, Greece
| | - Maria-Styliani Kalogirou
- First Department of Pediatric Surgery, Aristotle University of Thessaloniki General Hospital "G. Gennimatas", Thessaloniki, Greece
| | - Dimitrios Patoulias
- First Department of Internal Medicine, General Hospital "Hippokration", Thessaloniki, Greece.
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Ngo AV, Stanescu AL, Phillips GS. Neonatal Bowel Disorders: Practical Imaging Algorithm for Trainees and General Radiologists. AJR Am J Roentgenol 2018; 210:976-88. [PMID: 29528714 DOI: 10.2214/AJR.17.19378] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Neonatal bowel disorders require prompt and accurate diagnosis to avoid potential morbidity and mortality. Symptoms such as feeding intolerance, emesis, or failure to pass meconium may prompt a radiologic evaluation. CONCLUSION We discuss the most common neonatal bowel disorders and present a practical imaging algorithm for trainees and general radiologists.
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Buinoiu N, Panaitescu A, Demetrian M, Ionescu S, Peltecu G, Veduta A. Ultrasound prenatal diagnosis of typical megacystis, microcolon, intestinal hypoperistalsis syndrome. Clin Case Rep 2018; 6:855-858. [PMID: 29744072 PMCID: PMC5930184 DOI: 10.1002/ccr3.1481] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 02/10/2018] [Accepted: 02/14/2018] [Indexed: 12/13/2022] Open
Abstract
In the presence of megacystis in the second half of pregnancy, with increased amniotic fluid, especially in a female fetus, the most likely diagnostic result is megacystis, microcolon, intestinal hypoperistalsis syndrome, MMIHS. In these cases, the diagnosis of MMIHS should be strongly considered instead of lower urinary tract obstruction.
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Abstract
Megacystis, microcolon, intestinal hypoperistalsis is an uncommon condition presenting in neonatal age with features of intestinal obstruction and bladder evacuation abnormalities. We present here an infant girl with the diagnosis consistent with this entity.
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Affiliation(s)
- M Mantan
- Department of Pediatrics, Maulana Azad Medical College and Associated Hospitals, University of Delhi, New Delhi, India
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