[Hirschsprung-associated enterocolitis: Observational study in a paediatric emergency care unit]

Area of Science:

• Pediatric Gastroenterology
• Neonatal Surgery
• Pediatric Emergency Medicine

Background:

• Hirschsprung-associated enterocolitis (HAEC) is a severe complication of Hirschsprung's disease, leading to significant infant morbidity and mortality.
• Variable and non-specific symptoms of HAEC often delay or complicate diagnosis.
• Early identification and management of HAEC are crucial for improving patient outcomes.

Purpose of the Study:

• To identify clinical factors associated with HAEC diagnosis in children presenting to a pediatric emergency department.
• To evaluate the management strategies for suspected HAEC in this setting.

Main Methods:

• Retrospective descriptive study of patients with Hirschsprung's disease and enterocolitis symptoms.
• Inclusion criteria: pediatric emergency department visits between April 2011 and November 2015.
• Analytical multivariate analysis of epidemiological and clinical variables.

Main Results:

• 75 consultation episodes were analyzed; 52% were diagnosed with HAEC.
• Diarrhea was the most common presenting symptom (74.7%).
• Lethargy, abdominal distension, and abnormal X-ray findings were significantly associated with HAEC diagnosis. Hospital admission rate was 77.3%.

Conclusions:

• HAEC must be considered in all infants with Hirschsprung's disease presenting to the emergency department, particularly those with gastrointestinal symptoms, lethargy, abdominal distension, and radiographic abnormalities.
• Prompt initiation of diagnostic and therapeutic processes, including clinical observation or medical treatment, is recommended for suspected HAEC.