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Guidelines for the management of postoperative soiling in children with Hirschsprung disease

P Saadai1,2, A F Trappey3,4, A M Goldstein5

  • 1Division of Pediatric Surgery, Department of Surgery, University of California, Davis, CA, USA. psaadai@ucdavis.edu.

Pediatric Surgery International
|June 16, 2019
PubMed

Insights

Postoperative soiling is a common issue for children with Hirschsprung disease after pull-through surgery. This guideline offers a structured approach to diagnose and manage soiling, aiming to improve patient outcomes.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology

Background:

  • Hirschsprung disease often requires pull-through surgery.
  • Postoperative complications like soiling can impact quality of life.
  • A standardized management approach is needed for these challenges.

Purpose of the Study:

  • To provide a rational guideline for managing postoperative soiling in children with Hirschsprung disease.
  • To outline diagnostic methods and treatment strategies for soiling.
  • To optimize outcomes for patients experiencing soiling after surgery.

Main Methods:

  • Literature review by the American Pediatric Surgical Association Hirschsprung Disease Interest Group.
  • Expert group discussions and consensus building.
  • Development of a stepwise diagnostic and management algorithm.

Main Results:

  • Soiling causes are categorized into sensory abnormalities, sphincter control issues, and pseudo-incontinence.
  • A stepwise algorithm aids in diagnosis and treatment planning.
  • Expert consensus guides the management recommendations.

Conclusions:

  • A systematic approach to diagnosing and managing postoperative soiling in Hirschsprung disease is presented.
  • This guideline aims to standardize care and improve patient outcomes.
  • Effective management can lead to functional and comfortable stooling.

Keywords:
Bowel managementHirschsprung diseaseIncontinencePseudo-incontinencePull-throughSoiling

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