Hirschsprung's disease in Zaria, Nigeria: comparison of 2 consecutive decades

This is a retrospective study of 136 histologically confirmed cases of Hirschsprung's disease (HD) seen and treated in a single centre over 2 consecutive decades spanning the years from 1972 to 1991. Forty-six cases were seen in the 1st 10 years and 90 in the 2nd. Certain factors were considered to be responsible for the observed improvement during the 2nd decade; these included improvements in the mode of bowel preparation, the use of more effective antimicrobial agents with a wider spectrum of activity for prevention and treatment of established infections, and improvements in the pre-operative nutritional status of the patients and in the staging of the operations. Morbidity was minimal. Mortality dropped from 28.3% in the 1st decade to 5.6% in the 2nd. Causes of mortality in the 1st decade were pneumonia (8), aspiration of gastric contents (2), undernutrition (2) and haemorrhage from a dislodged clamp several days following a Duhamel procedure (1). In the early part of the 2nd decade, three patients died from anastomotic dehiscence following the Swenson procedure and two from aspiration pneumonia.