Huimin Xia, Liankang Wu, Zhiqiang Zhu, Hongwen Xu, Shuiqiong Li, Jiaxiong Xie

Department of Pediatric Surgery, Guangzhou Children Hospital, Guangzhou, China


Background/Purpose: Enterocolitis continues to be the major cause of morbidity and mortality in newborn with Hirschsprung's disease. The exact etiology of Hirschsprung's-associated enterocolitis is not known.This study was therefore identified risk factors associated with  hirschsprng of newborn

Methods:  147 newborn with HD treated from 1995 through 2000 at our Hospital were assessed. Risk factors were examined in following items: patient factors (gender, age at diagnosis, age and weight at pull-through), technical factors (type of repair, number of stages, location of transition zone, previous EC),

Results: In 107 patients, the incidence of EC was 34.44%(n=31). The extent of aganglionosis in the all newborn with EC was as follows:common type restricted to the rectosigmoid or descending colon (n =19 ,61.29 %); long segment (n = 9,29.03%); total colon (n=3,9.68%),unknown length because of death without autopsy (n =10,32.4%) . The median age at operation was 19.1 day .Surgical procedures used for short and common-segment disease were Soave with colostomy (n = 96),  for long-segment disease were Martin (n = 3), and ileostomy only in = 2). and the others were not classified because of death before curative surgery. Enterocolitis (EC) was the most common cause of death (five cases) The risk of EC was no significantly increased by gender, age at diagnosis, age and weight The presence of EC significantly increased the number of hospital admissions, mean length of stay, and total treatment cost.

Conclusion: HEC can be characterized as abdominal distension and explosive diarrhea associated with the intestinal cutoff sign and the occurrence of explosive diarrhea in any newborn with HD is suggestive of HEC, even in the absence of systemic symptoms, and should be treated to avoid the morbidity and potential mortality of HEC. The most effective method of prophylaxis and treatment of enterocolitis is decompression of a stretched colon with the aid of the irrigation technique.