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Enterocolitis in Hirschsprung's disease
Authors:P. M. R. Carneiro  R. J. Brereton  D. P. Drake  E. M. Kiely  L. Spitz  R. Turnock
Affiliation:(1) Department of Surgery, Hospital for Sick Children, London, UK;(2) Nuffield Department of Surgery, Institute of Child Health, 30 Guilford Street, WCIN 1EH London, UK
Abstract:
During the 5 years 1985–1989, 24 (32%) of 76 patients treated for Hirschsprung's disease (HD) developed enterocolitis, this being present at the time of diagnosis in 10 (13%) infants, 7 of whom were neonates. HD presented as necrotizing enterocolitis in 5 neonates, 4 of whom were premature. The enterocolitis developed postoperatively in 14 (18%) patients, in 7 after an enterostomy and in 7 after a pull-through procedure. Recurrent episodes of enterocolitis occurred in 4 of the patients who developed postoperative enterocolitis. The risk of enterocolitis was increased in girls, in patients with associated Down's syndrome, those with a family history of HD, and those managed by an endorectal pull-through procedure. The Duhamel procedure was associated with a low (5%) incidence of postoperative enterocolitis. Long-segment aganglionosis was not associated with an increased risk of enterocolitis and preoperative enterocolitis conferred no increased risk of postoperative enterocolitis.
Keywords:Enterocolitis  Hirschsprung's disease
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