Hirschsprung associated enterocolitis (HAEC) is a common and sometimes life-threatening complication of Hirschsprung disease (HSD). Presenting either before or after definitive surgery for HSD, it may manifest clinically as abdominal distension and explosive diarrhea, along with emesis, fever, lethargy and even shock. The pathogenesis of HAEC involves a complex interplay between a dysfunctional enteric nervous system, abnormal mucin production, insufficient immunoglobulin secretion and unbalanced intestinal microflora. Early recognition of HAEC and preventive practices such as rectal wash outs following a pull through can lead to improved outcomes. Treatment strategies for acute HAEC include timely resuscitation, colonic decompression and antibiotics. Recurrent or persistent HAEC requires evaluation for mechanical obstruction or residual aganglionosis and may require surgical treatment with posterior myectomy or redo pull through.
Aim of work:
This study aimed to evaluate HAEC as a postoperative complication in children who were admitted after pull-through regarding the type of surgery, incidence, clinical presentation, sepsis workup, and management in Alexandria University Children's Hospital at El- Shatby.