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Published on: April 26, 2019

Defecation disorders in children after surgery for Hirschsprung disease

Bruno P Chumpitazi1, Samuel Nurko

  • 1Center for Motility and Functional Gastrointestinal Disorders, Children's Hospital Boston, Boston, MA 02115, USA.

Journal of Pediatric Gastroenterology and Nutrition
|June 23, 2011
PubMed

Insights

Children with Hirschsprung disease (HD) and defecation disorders (DDs) after surgery often improve with a systematic algorithm. This approach leads to favorable long-term outcomes for most pediatric patients.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Clinical Outcomes Research

Background:

  • Hirschsprung disease (HD) frequently leads to persistent defecation disorders (DDs) post-corrective surgery (CS).
  • These disorders include constipation, fecal incontinence, and enterocolitis, impacting quality of life.

Purpose of the Study:

  • To determine diagnoses and therapies for protracted DDs in children with HD after CS.
  • To evaluate long-term clinical outcomes using a systematic management algorithm.

Main Methods:

  • Retrospective review of pediatric patients with HD and DDs after CS.
  • Systematic algorithm application for diagnosis and treatment at a tertiary care center.
  • Clinical outcomes categorized based on symptom severity and treatment response.

Main Results:

  • Fifty-seven children were analyzed; 89.5% presented with obstructive symptoms or enterocolitis.
  • Common etiologies included nonrelaxing anal sphincter (38.6%) and residual aganglionosis (15.8%).
  • Overall, 66.7% achieved excellent or good clinical outcomes, with enterocolitis patients showing better results.

Conclusions:

  • A systematic algorithm effectively manages protracted defecation disorders in children with HD post-surgery.
  • Most children experience favorable long-term clinical outcomes with this structured approach.
Abstract

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