Enterocolitis in a Child With Hirschsprung Disease.

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Emergency Medicine

Background:

• Hirschsprung disease is a congenital condition requiring surgical correction.
• Hirschsprung-associated enterocolitis (HAEC) is a severe complication.
• Limited emergency medicine literature addresses HAEC risk in patients with Hirschsprung disease.

Observation:

• A 6-month-old infant with a history of Hirschsprung disease presented with viral gastroenteritis.
• Initially discharged due to stable condition, the infant returned days later with severe diarrhea.
• The infant required pediatric intensive care unit admission for enterocolitis and shock.

Findings:

• A history of Hirschsprung disease significantly increases the risk of severe enterocolitis and shock.
• Seemingly benign gastrointestinal illnesses can precipitate life-threatening complications in these patients.
• Prompt recognition and intervention are crucial for managing HAEC.

Implications:

• Emergency physicians must maintain a high index of suspicion for HAEC in patients with Hirschsprung disease.
• A history of Hirschsprung disease warrants surgical consultation and potential admission for gastrointestinal illness.
• Early surgical evaluation can alter management and improve outcomes for patients with Hirschsprung disease.