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ARTICLE TYPE : CASE REPORT

Published on :   17 Jan 2026, Volume - 2
Journal Title :   WebLog Journal of Pulmonology and Respiratory Medicine | WebLog J Pulmonol Respir Res
Source URL:   weblog iconhttps://weblogoa.com/articles/wjprm.2026.a1701
Permanent Identifier (DOI) :  doi iconhttps://doi.org/10.5281/zenodo.18373124

Recurrent Respiratory Tract Infections and Pneumonia in a 4‑Year‑Old Girl with Unrecognized Hypoganglionosis Successfully Treated with Transanal Endosurgical Modified Anorectal Myomectomy

Govani DR 1
Mehta AR 2
Midha PK 3
Govani ND 1
Panchasara NG 1
Patel RR 1
Patel RV 1 *
1Department of Pediatrics and Pediatric Surgery, Postgraduate Institute of Child Health & Research and KT Children Govt. University Teaching Hospital, Rajkot 360001, Gujarat, India
2Formerly Head, Department of Surgery at Tata Memorial Hospital, Mumbai, India
3J. Watumull Global Hospital & Research Centre, Delwara Road, Mount Abu, Rajasthan 307501, India Affiliated to Medical Faculty of God Fatherly Spiritual University, Mount Abu, Rajasthan, India

Abstract

We report a 4‑year‑old girl with recurrent respiratory tract infections and multiple episodes of pneumonia. Despite repeated hospital admissions, the underlying cause remained elusive until severe fecal retention was identified as a contributing factor. Further evaluation revealed previously unrecognized hypoganglionosis. Imaging demonstrated massive fecal loading with diaphragmatic elevation. Rectal biopsies confirmed reduced ganglion cell density consistent with hypoganglionosis. The patient underwent transanal endosurgical modified anorectal myomectomy. Postoperatively, she experienced complete resolution of constipation, improved respiratory mechanics, and cessation of recurrent infections on long term follow up.

Keywords: Recurrent Respiratory Tract Infections; Pneumonia; Pediatric Hypoganglionosis; Chronic Constipation; Malnutrition; Aspiration Pneumonia; Gastrointestinal Motility Disorder; Transanal Endosurgical Approach; Modified Anorectal Myomectomy; Pediatric Surgery

Citation

Govani DR, Mehta AR, Midha PK, Govani ND, Panchasara NG, Patel RR, et al. Recurrent Respiratory Tract Infections and Pneumonia in a 4-Year-Old Girl with Unrecognized Hypoganglionosis Successfully Treated with Transanal Endosurgical Modified Anorectal Myomectomy. WebLog J Pulmonol Respir Res. wjprm.2026. a1701. https://doi.org/10.5281/zenodo.18373124
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