{ "schemaVersion": 2, "eyebrow": "Pediatric Surgery", "title": "Hirschsprung Disease", "summary": "Suspect Hirschsprung disease in neonatal distal bowel obstruction or refractory constipation with delayed meconium. Stabilize enterocolitis and obstruction first, establish aganglionosis by rectal pathology, define disease extent for pull-through planning, and systematically evaluate postoperative obstruction, soiling, and recurrent enterocolitis.", "seoDescription": "Point-of-care guide to diagnosing, stabilizing, surgically managing, and following children with Hirschsprung disease and enterocolitis.", "clinicalQuestion": "How should physicians diagnose, stabilize, treat, and monitor children with suspected or confirmed Hirschsprung disease?", "specialty": "Pediatric Gastroenterology and Pediatric Surgery", "audience": "U.S. physicians and medical trainees", "tags": [ "Hirschsprung disease", "congenital aganglionosis", "rectal suction biopsy", "Hirschsprung-associated enterocolitis", "pull-through surgery", "neonatal bowel obstruction" ], "keyTakeaways": [ "Delayed meconium, vomiting, distension, or enterocolitis in an infant should trigger evaluation for distal intestinal obstruction, including Hirschsprung disease.[1]", "Confirm suspected classic Hirschsprung disease with rectal biopsy demonstrating absent ganglion cells; contrast enema and anorectal manometry are adjuncts rather than substitutes for pathology.[14][15]", "Treat suspected Hirschsprung-associated enterocolitis as an urgent complication; distension, fever, diarrhea, lethargy, or bloody stools may occur before or after pull-through.[16]", "Definitive management is resection or bypass of the aganglionic segment with pull-through of ganglionated bowel; operative strategy depends on disease extent, clinical stability, and local expertise.[1][3][21]", "Post-pull-through constipation, obstruction, soiling, and enterocolitis require structured reassessment for anatomic obstruction, residual aganglionosis, and functional bowel disorders rather than empiric labeling as treatment failure.[10][23][24]" ], "sections": [ { "id": "triage-and-stabilization", "eyebrow": "First decision", "heading": "Identify obstruction and enterocolitis requiring urgent management", "intro": "Prioritize physiologic stability and decompression before definitive diagnostic or operative planning.", "paragraphs": [ "In a neonate or young infant with delayed passage of meconium, progressive abdominal distension, vomiting, or feeding intolerance, treat the presentation as distal bowel obstruction while evaluating for Hirschsprung disease. Hirschsprung disease is most often diagnosed in the first year of life, and approximately 90% of affected infants are diagnosed during the neonatal period.[1][4]", "Escalate immediately for suspected Hirschsprung-associated enterocolitis (HAEC), particularly when abdominal distension is accompanied by fever, diarrhea, colicky pain, lethargy, or blood-stained stool. HAEC can be the presenting event or occur after corrective surgery and remains a major source of morbidity and mortality.[16][17]", "Arrange urgent pediatric surgical involvement for obstruction or suspected HAEC. The immediate procedural objective is decompression of obstructed bowel; definitive pull-through planning follows stabilization and histologic confirmation of aganglionosis.[1][21]" ], "bullets": [ "Ask specifically about timing of first meconium, bilious emesis, progressive distension, explosive stool after rectal examination or decompression, prior enterocolitis episodes, and previous pull-through or stoma surgery.[1][16]", "Increase vigilance for HAEC in children with trisomy 21; trisomy 21 is associated with approximately twice the HAEC incidence reported in non-trisomy 21 Hirschsprung disease.[16]" ], "subsections": [], "table": { "caption": "", "columns": [], "rows": [] } }, { "id": "confirm-diagnosis-and-map-extent", "eyebrow": "Diagnostic pathway", "heading": "Confirm aganglionosis with rectal pathology and use adjunct tests to define anatomy", "intro": "A functional-obstruction phenotype should proceed to tissue diagnosis rather than prolonged empiric constipation treatment.", "paragraphs": [ "The diagnostic endpoint is rectal histology showing absence of ganglion cells in the distal rectum. Rectal suction biopsy is a standard diagnostic tool; full-thickness rectal biopsy is an alternative when suction sampling is nondiagnostic or clinical-pathologic discordance persists.[14][15]", "Use contrast enema to support the diagnosis and assist operative planning. A transition zone between dilated proximal bowel and narrowed distal colon is characteristic, but it does not replace biopsy confirmation.[14]", "Anorectal manometry can provide supportive physiologic information through assessment of the rectoanal inhibitory reflex (RAIR), but a present RAIR does not exclude rare atypical patterns. In reported single-zonal aganglionosis, RAIR and rectal biopsies showed ganglion cells despite persistent obstructive symptoms; resection pathology identified a segmental aganglionic zone.[14]" ], "bullets": [], "subsections": [ { "heading": "When the usual tests conflict", "paragraphs": [ "Do not close the evaluation solely because a distal rectal biopsy shows ganglion cells or RAIR is present when the child has persistent obstructive symptoms and imaging suggests a transition zone. Discuss repeat or more proximal full-thickness sampling with pediatric surgery and pathology because atypical zonal aganglionosis has been described.[14]" ], "bullets": [] } ], "table": { "caption": "Tests used to establish or refine the diagnosis of Hirschsprung disease.[14][15]", "columns": [ "Test", "Decision contribution", "Important limitation or next action" ], "rows": [ [ "Rectal suction biopsy", "Absence of ganglion cells supports Hirschsprung disease confirmation.[14][15]", "If nondiagnostic or discordant with the clinical phenotype, obtain surgical-pathology review and consider full-thickness biopsy.[14][15]" ], [ "Full-thickness rectal biopsy", "Provides an alternative histologic method for confirming absence of ganglion cells.[15]", "Consider when suction biopsy does not resolve a high-suspicion presentation.[15]" ], [ "Contrast enema", "A transition zone between proximal dilation and distal narrowing supports a distal functional obstruction pattern.[14]", "Use as an adjunct; histology remains the diagnostic confirmation.[14][15]" ], [ "Anorectal manometry", "Assesses RAIR as supportive physiologic evidence.[14]", "A present RAIR does not eliminate concern when symptoms and imaging remain strongly discordant.[14]" ] ] } }, { "id": "definitive-surgical-management", "eyebrow": "Definitive treatment", "heading": "Select pull-through strategy after decompression and definition of ganglionated bowel", "intro": "The operative goal is relief of obstruction while preserving continence and minimizing pelvic injury.", "paragraphs": [ "Definitive treatment removes or bypasses the aganglionic segment and brings normally ganglionated bowel to the anus through a pull-through procedure. Traditional staged management uses a proximal diverting ostomy followed by a later pull-through, whereas single-stage operations are also used; selection depends on disease extent, bowel condition, and clinical stability.[1][3][21]", "For short-segment disease, transanal pull-through techniques include Soave and Swenson approaches. The Soave approach retains a rectal muscular cuff to reduce risk of pelvic autonomic, urethral, prostatic, or vaginal injury; the Swenson approach more completely removes affected rectal wall and may reduce postoperative obstructive symptoms, with tradeoffs that require surgeon-specific selection.[23]", "Long-segment disease requires planning beyond a standard rectosigmoid pull-through and should be managed in a pediatric colorectal program. A systematic review and specialty guidance address management and outcomes for long-segment Hirschsprung disease, reflecting the greater anatomic and functional complexity of this subgroup.[1]" ], "bullets": [ "Before definitive surgery, document the proximal level of ganglionated bowel using operative-pathology assessment to avoid pull-through of aganglionic bowel.[1][14]", "A diversion-first approach remains relevant when the child cannot safely undergo primary reconstruction because of severe obstruction, enterocolitis, or complex disease extent.[1][21]" ], "subsections": [], "table": { "caption": "Operative choices are individualized by disease extent and procedural tradeoffs.[1][3][21][23]", "columns": [ "Clinical context", "Operative consideration", "Key tradeoff" ], "rows": [ [ "Stable child with disease suitable for primary reconstruction", "Single-stage pull-through may avoid a planned stoma and later reversal.[21]", "Requires safe decompression, operative definition of ganglionated bowel, and appropriate surgical conditions.[1][21]" ], [ "Unstable child or severe obstructive/enterocolitis presentation", "Proximal diversion followed by later pull-through is a traditional staged pathway.[21]", "Adds operations but separates acute stabilization from definitive reconstruction.[21]" ], [ "Short-segment disease", "Transanal Soave or Swenson pull-through are established approaches.[23]", "Soave seeks to reduce pelvic-structure injury; Swenson more completely removes affected rectal wall and may reduce obstructive symptoms.[23]" ], [ "Long-segment disease", "Plan in an experienced pediatric colorectal setting with disease-extent-specific reconstruction.[1]", "Functional outcomes and reconstruction options differ from rectosigmoid disease.[1]" ] ] } }, { "id": "enterocolitis-and-postoperative-surveillance", "eyebrow": "Complications", "heading": "Treat recurrent symptoms after pull-through as a diagnostic problem", "intro": "Postoperative symptoms are common enough to require active surveillance and etiologic reassessment.", "paragraphs": [ "HAEC remains possible after definitive surgery. Postoperative stenosis and younger age at diagnosis have been associated with greater risk of postoperative HAEC admission, so recurrent distension, diarrhea, fever, lethargy, or bloody stool should prompt urgent assessment for enterocolitis and mechanical obstruction rather than reassurance alone.[16][18]", "For postoperative obstruction or constipation, evaluate for anastomotic stricture, retained obstructing anatomy, residual aganglionosis, or functional constipation. Post-pull-through complications reported across surgical series include recurrent constipation, fecal soiling, enterocolitis, bowel prolapse, anastomotic fistula, obstruction, and stenosis.[10][23][24]", "Do not equate recurrent constipation with failed pull-through without assessment. Functional constipation can occur after surgery, while persistent obstruction may reflect a correctable structural or histopathologic problem.[23]", "Discuss family-directed monitoring at each follow-up visit: stooling pattern, need for enemas or irrigations, continence or soiling, distension, enterocolitis admissions, growth, and the effect of bowel symptoms on daily function. Long-term studies assess voluntary bowel movements without enemas or rectal/colonic irrigation and use standardized bowel-function measures, underscoring the need to measure function rather than only surgical survival.[2]" ], "bullets": [ "Urgently reassess a postoperative child with abdominal distension plus fever, diarrhea, lethargy, colicky pain, or bloody stool for HAEC.[16]", "If obstructive symptoms recur, specifically look for postoperative stenosis because it is associated with postoperative enterocolitis risk.[18]", "In a historical single-center trial, routine postoperative normal-saline rectal irrigations were associated with fewer enterocolitis cases than no routine irrigation (3 of 40 versus 34 of 95); use should follow the treating colorectal program's protocol.[17]" ], "subsections": [ { "heading": "Counseling on expected long-term burden", "paragraphs": [ "Even after corrective surgery, chronic bowel symptoms and repeat hospital care can persist. In one Soave series, long-term constipation and obstruction were each reported in 27.3%, enterocolitis in 14.5%, and fecal incontinence in 5.5%; these single-center results should inform surveillance discussions rather than predict an individual child's outcome.[24]" ], "bullets": [] } ], "table": { "caption": "Post-pull-through symptom pattern and next diagnostic focus.[10][16][18][23][24]", "columns": [ "Presentation", "Priority concern", "Next action" ], "rows": [ [ "Distension with fever, diarrhea, lethargy, colicky pain, or bloody stool", "HAEC, with possible coexisting obstruction.[16]", "Urgent clinical assessment, decompression-focused management, and pediatric surgical involvement.[1][16]" ], [ "Recurrent constipation or obstructive symptoms", "Anastomotic stenosis, residual obstructing pathology, residual aganglionosis, or functional constipation.[10][18][23]", "Assess anatomy and pathology in coordination with the pull-through team before assigning functional constipation alone.[10][23]" ], [ "Soiling or fecal incontinence", "Postoperative bowel dysfunction requiring structured bowel-function assessment.[2][10][24]", "Document stooling, continence, irrigations/enemas, and impact on daily functioning to guide a bowel-management plan.[2][10]" ], [ "Repeated enterocolitis admissions", "Recurrent HAEC, particularly with stenosis or other obstructive physiology.[16][18]", "Reevaluate for a correctable obstruction and review the postoperative decompression plan.[17][18]" ] ] } }, { "id": "associated-conditions-and-referral", "eyebrow": "Risk stratification", "heading": "Screen for relevant associated conditions and refer early for complex disease", "intro": "Associated syndromes and disease extent change counseling, complication surveillance, and operative planning.", "paragraphs": [ "Examine and review the history for associated congenital anomalies and syndromic disease. Hirschsprung disease may occur with Down syndrome and multiple endocrine neoplasia type IIA; trisomy 21 also increases HAEC risk and should lower the threshold for enterocolitis assessment.[1][16]", "Refer early to a pediatric surgeon with Hirschsprung and colorectal expertise when there is long-segment disease, recurrent enterocolitis, discordant manometry and pathology, persistent postoperative obstruction, or need for stoma revision. These scenarios require coordinated interpretation of contrast imaging, operative anatomy, and rectal or bowel pathology.[1][10][14]" ], "bullets": [], "subsections": [], "table": { "caption": "", "columns": [], "rows": [] } } ], "faq": [], "references": [ { "number": 1, "title": "Hirschsprung's disease - Symptoms, diagnosis and treatment | BMJ Best Practice", "detail": "bestpractice.bmj.com", "url": "https://bestpractice.bmj.com/topics/en-us/750", "authors": "bestpractice.bmj.com", "host": "bestpractice.bmj.com" }, { "number": 2, "title": "Outcomes at five to eight years of age for children with ...", "detail": "adc.bmj.com", "url": "https://adc.bmj.com/content/archdischild/106/5/484.full.pdf", "authors": "adc.bmj.com", "host": "adc.bmj.com" }, { "number": 3, "title": "Surgical management of short-segment Hirschsprung ...", "detail": "wjps.bmj.com", "url": "https://wjps.bmj.com/content/7/4/e000916#!", "authors": "wjps.bmj.com", "host": "wjps.bmj.com" }, { "number": 4, "title": "Hirschsprung's disease in the UK and Ireland: incidence ...", "detail": "adc.bmj.com", "url": "https://adc.bmj.com/content/102/8/722", "authors": "adc.bmj.com", "host": "adc.bmj.com" }, { "number": 5, "title": "Diagnosis and management in Rubinstein-Taybi syndrome: first international consensus statement | Journal of Medical Genetics", "detail": "jmg.bmj.com", "url": "https://jmg.bmj.com/content/61/6/503", "authors": "jmg.bmj.com", "host": "jmg.bmj.com" }, { "number": 6, "title": "development of a Hirschsprung's disease core outcome set", "detail": "adc.bmj.com", "url": "https://adc.bmj.com/content/102/12/1143", "authors": "adc.bmj.com", "host": "adc.bmj.com" }, { "number": 7, "title": "Childhood outcomes in children with Hirschsprung disease", "detail": "fg.bmj.com", "url": "https://fg.bmj.com/content/early/2026/01/02/flgastro-2025-103478", "authors": "fg.bmj.com", "host": "fg.bmj.com" }, { "number": 8, "title": "Impact of enteric neuronal loss on intestinal cell composition", "detail": "www.cell.com", "url": "https://www.cell.com/iscience/fulltext/S2589-0042(26)00866-7?uuid=", "authors": "www.cell.com", "host": "www.cell.com" }, { "number": 9, "title": "Hirschsprung's disease. 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Verify recommendations against current guidance and patient-specific factors.", "citations": [ { "number": 1, "title": "Hirschsprung's disease - Symptoms, diagnosis and treatment | BMJ Best Practice", "detail": "bestpractice.bmj.com", "url": "https://bestpractice.bmj.com/topics/en-us/750", "authors": "bestpractice.bmj.com", "host": "bestpractice.bmj.com", "snippet": "Kawaguchi AL, Guner YS, Sømme S, et al. Management and outcomes for long-segment Hirschsprung disease: a systematic review from the APSA outcomes and evidence based practice committee. J Pediatr Surg. 2021 Sep;56(9):1513-23.Full textAbstract\n\nGosain A, Frykman PK, Cowles RA, et al. Guidelines for th", "score": 0.6693348 }, { "number": 2, "title": "Outcomes at five to eight years of age for children with ...", "detail": "adc.bmj.com", "url": "https://adc.bmj.com/content/archdischild/106/5/484.full.pdf", "authors": "adc.bmj.com", "host": "adc.bmj.com", "snippet": "outcome in patients with Hirschsprung disease: a systematic review. J Pediatr Urol 2016;12:352–60. 16 Diseth TH, Bjørnland K, Nøvik TS, et al. Bowel function, mental health, and psychosocial function in adolescents with Hirschsprung’s disease. Arch Dis Child 1997;76:100–6. 17 Amin R, Knezevich M, Li", "score": 0.4622066 }, { "number": 3, "title": "Surgical management of short-segment Hirschsprung ...", "detail": "wjps.bmj.com", "url": "https://wjps.bmj.com/content/7/4/e000916#!", "authors": "wjps.bmj.com", "host": "wjps.bmj.com", "snippet": "Hirschsprung disease (HSCR) is the most common congenital motility disorder of the intestine, characterized by the absence of ganglion cells in the myenteric ...Read more", "score": 0.35622323 }, { "number": 4, "title": "Hirschsprung's disease in the UK and Ireland: incidence ...", "detail": "adc.bmj.com", "url": "https://adc.bmj.com/content/102/8/722", "authors": "adc.bmj.com", "host": "adc.bmj.com", "snippet": "by TJ Bradnock · 2017 · Cited by 145 — Contemporary population-based studies confirm that around 90% of infants with HD are diagnosed within the neonatal period1 and late-presenting cases are rare.28", "score": 0.30464175 }, { "number": 5, "title": "Diagnosis and management in Rubinstein-Taybi syndrome: first international consensus statement | Journal of Medical Genetics", "detail": "jmg.bmj.com", "url": "https://jmg.bmj.com/content/61/6/503", "authors": "jmg.bmj.com", "host": "jmg.bmj.com", "snippet": "Constipation is extremely prevalent in RTS across all age groups throughout the lifespan.41 45 The cause remains unknown, Hirschsprung disease or other identifiable aetiologies do not occur more frequently than in the general population. Additional investigations are only indicated if symptomatology", "score": 0.2488722 }, { "number": 6, "title": "development of a Hirschsprung's disease core outcome set", "detail": "adc.bmj.com", "url": "https://adc.bmj.com/content/102/12/1143", "authors": "adc.bmj.com", "host": "adc.bmj.com", "snippet": "by BSR Allin · 2017 · Cited by 67 — Outcome reporting heterogeneity in published research is preventing identification of gold standard treatments for infants with Hirschsprung's disease.Read more", "score": 0.22114074 }, { "number": 7, "title": "Childhood outcomes in children with Hirschsprung disease", "detail": "fg.bmj.com", "url": "https://fg.bmj.com/content/early/2026/01/02/flgastro-2025-103478", "authors": "fg.bmj.com", "host": "fg.bmj.com", "snippet": "by KL Harron · 2026 — Children with HSCR experience substantially higher hospital readmission rates, more surgeries and greater mortality up to age 14 than their", "score": 0.20798618 }, { "number": 8, "title": "Impact of enteric neuronal loss on intestinal cell composition", "detail": "www.cell.com", "url": "https://www.cell.com/iscience/fulltext/S2589-0042(26)00866-7?uuid=", "authors": "www.cell.com", "host": "www.cell.com", "snippet": "by NJM Kakiailatu · 2026 · Cited by 1 — Hirschsprung disease (HSCR) is a congenital disorder characterized by the absence of an enteric nervous system (ENS) in the distal gut.", "score": 0.15591232 }, { "number": 9, "title": "Hirschsprung's disease. Management", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/10.1111/apt.18068", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com", "snippet": "The objective of the treatment for children with HD is to alleviate symptoms, correct underlying bowel obstruction and improve quality of life.", "score": 0.5383771 }, { "number": 10, "title": "Evaluation and Management of Postsurgical Patient With ...", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/10.1097/MPG.0000000000003717", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com", "snippet": "Guidelines for the management of postoperative soiling in children with Hirschsprung disease. Pediatr Surg Int 2019; 35: 829–34. 10.1007", "score": 0.50022036 }, { "number": 11, "title": "Updated European Reference Network for rare Inherited ...", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/10.1002/jpn3.70442", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com", "snippet": "by D Rossi · Cited by 2 — A European, multidisciplinary ERNICA guideline for the management of rectosigmoid Hirschsprung's disease (HSCR) was published in 2018. The", "score": 0.44420364 }, { "number": 12, "title": "Japanese clinical practice guidelines for allied disorders of ...", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/10.1111/ped.13559", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com", "snippet": "We herein outline the newly established Japanese clinical practice guidelines for allied disorders of Hirschsprung's disease. Given that the", "score": 0.4098117 }, { "number": 13, "title": "Screening of undernutrition in children with Hirschsprung ...", "detail": "aspenjournals.onlinelibrary.wiley.com", "url": "https://aspenjournals.onlinelibrary.wiley.com/doi/10.1002/jpen.2440", "authors": "aspenjournals.onlinelibrary.wiley.com", "host": "aspenjournals.onlinelibrary.wiley.com", "snippet": "by D Wang · 2023 · Cited by 24 — Undernutrition is associated with poor clinical outcomes. This study aims to describe the nutrition status among patients with Hirschsprung", "score": 0.19502655 }, { "number": 14, "title": "Atypical Hirschsprung's Disease: Single Zonal... : American Journal of Gastroenterology", "detail": "journals.lww.com", "url": "https://journals.lww.com/ajg/fulltext/00000434-201710001-02387~atypical-hirschsprungs-disease-single-zonal-aganglionosis", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "A full term male infant presented with bilious emesiss, abdominal distension and delayed passage of meconium at 48 hours old. Contrast enema demonstrated transition zone at the junction of the distal descending and sigmoid colon (figure 3. b & c). Suction rectal biopsy returned positive for calretin", "score": 0.83678174 }, { "number": 15, "title": "A Rare Case Report of Hirschsprung's Disease-simulating...", "detail": "journals.lww.com", "url": "https://journals.lww.com/njom/fulltext/2025/07000/a_rare_case_report_of_hirschsprung_s.12.aspx?context=latestarticles", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "Histological confirmation of the diagnosis is usually made using either a submucosal or whole thickness rectal biopsy is linked to either abnormal barium enema", "score": 0.3622926 }, { "number": 16, "title": "Current understanding of Hirschsprung-associated enterocolitis: Pathogenesis, diagnosis and treatment", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S1055858622000233", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "This article reviews our current understanding of HAEC pathogenesis, diagnosis, and treatment with discussion of areas of ongoing research, controversy, and future investigation.\n\n## Access through your organization\n\nCheck access to the full text by signing in through your organization.\n\nAccess thro", "score": 0.71377134 }, { "number": 17, "title": "Rectal irrigations for the prevention of postoperative enterocolitis in Hirschsprung's disease - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/pii/0022346895906819", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "Title: Rectal irrigations for the prevention of postoperative enterocolitis in Hirschsprung's disease - ScienceDirect\n# Rectal irrigations for the prevention of postoperative enterocolitis in Hirschsprung's disease☆. The purpose of this clinical trial was to examine the role of rectal irrigations in", "score": 0.49831602 }, { "number": 18, "title": "Older age at diagnosis of Hirschsprung disease decreases risk of postoperative enterocolitis, but resection of additional ganglionated bowel does not - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/pii/S0022346808001760", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "Title: Older age at diagnosis of Hirschsprung disease decreases risk of postoperative enterocolitis, but resection of additional ganglionated bowel does not - ScienceDirect\n# Older age at diagnosis of Hirschsprung disease decreases risk of postoperative enterocolitis, but resection of additional gan", "score": 0.40683898 }, { "number": 19, "title": "Advances in Evaluation of Chronic Diarrhea in Infants", "detail": "www.gastrojournal.org", "url": "https://www.gastrojournal.org/article/S0016-5085(18)30440-2/fulltext", "authors": "www.gastrojournal.org", "host": "www.gastrojournal.org", "snippet": "by JR Thiagarajah · 2018 · Cited by 249 — Hirschsprung's disease can rarely present with diarrhea, and should also be considered. ... Making a definitive diagnosis: successful clinical application of", "score": 0.3380339 }, { "number": 20, "title": "Childhood Functional Gastrointestinal Disorders: Neonate/ ...", "detail": "www.gastrojournal.org", "url": "https://www.gastrojournal.org/article/S0016-5085(16)00182-7/fulltext", "authors": "www.gastrojournal.org", "host": "www.gastrojournal.org", "snippet": "by MA Benninga · 2016 · Cited by 1137 — This article provides a description, assessment, and analysis of each FGID that affects the neonate/toddler age group. Hirschsprung's disease, spinal problems,", "score": 0.33665863 }, { "number": 21, "title": "Single-stage operations for Hirschsprung's disease", "detail": "www.gastrojournal.org", "url": "https://www.gastrojournal.org/article/S0016-5085(01)70292-2/fulltext", "authors": "www.gastrojournal.org", "host": "www.gastrojournal.org", "snippet": "by BW Warner · 2001 · Cited by 11 — The traditional management of Hirschsprung's disease has been the creation of a proximal diverting ostomy. This is followed by a second operation in which a", "score": 0.24199551 }, { "number": 22, "title": "Lack of Mucosal Cholinergic Innervation Is Associated With ...", "detail": "www.gastrojournal.org", "url": "https://www.gastrojournal.org/article/S2352-345X(21)00056-4/fulltext", "authors": "www.gastrojournal.org", "host": "www.gastrojournal.org", "snippet": "by S Keck · 2021 · Cited by 38 — Hirschsprung's disease (HSCR) is a congenital intestinal motility disorder defined by the absence of enteric neuronal cells (ganglia) in the distal gut.Read more", "score": 0.23797458 }, { "number": 23, "title": "Transanal pullthrough Soave and Swenson techniques for pediatric patients with Hirschsprung disease - PMC", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5348161", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "recurrent constipation, fecal soiling, enterocolitis, bowel prolapse, and anastomotic fistula.[14][15] In our study, the overall postoperative complication rate in the Swenson group was 15.2% and 30.4% in the Soave group (P = 0.001). The perianal excoriation rate in the Swenson group (17.4%) was much", "score": 0.78074646 }, { "number": 24, "title": "Early and long-term complications following transanal pull through Soave technique in infants with Hirschsprung’s disease - PMC", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6853039", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "| Complications | Age of patients | |\n --- \n| Less than 5 months (N) | 5 months to 2 years (N) |\n| Death | 0 | 0 |\n| Leak of anastomosis | 0 | 0 |\n| Stricture (stenosis) | 1 | 0 |\n| Infection | 0 | 0 |\n| Obstruction | 26 | 3 |\n| Constipation | 11 | 4 |\n| Enterocolitis | 5 | 3 |\n| Fecal Incontinency ", "score": 0.78014404 } ], "publishedAt": "2026-08-24T18:03:44.348753+00:00", "updatedAt": "2026-08-24T18:03:44.348753+00:00", "readingMinutes": 5, "slug": "hirschsprung-disease" }