Postoperative mortality in Hirschsprung's disease

The main factor causing a fatal outcome as well as the serious life threatening complications is anastomotic dehiscence. On the basis of our retrospective study we will sum up the following possible factors (not in order of importance): 1. Faulty suture techniques. 2. Pelvic seroma, haematoma or abscess with breakthrough into the lumen. 3. Tension on the suture line. 4. Deficient blood supply of either the distal colon, stump or the remaining rectum. Finally we would, on the basis of our study, like to make a plea for more and better colostomies or ileostomies; preoperatively as therapy in the sick child whose condition does not improve promptly with a rectal tube and, lastly, as postoperative cover to protect whatever anastomosis has been performed.