CAPS original paperPostoperative Hirschsprung's enterocolitis after minimally invasive Swenson's procedure
Section snippets
Materials and methods
A retrospective chart review of all children having surgery for HD by 4 pediatric surgeons at McMaster Children's Hospital from 1995 to 2006 was approved by the research ethics board. We excluded patients who were older than 18 years, had an open pullthrough, had total colonic aganglionosis, or had a previous pullthrough at another institution. For the purposes of this study, an episode of HEC was recorded if it had been diagnosed by the attending surgeon (face sheet, discharge diagnosis,
Results
Fifty-two patients with HD were found to fit our inclusion criteria, 25 with a LapSwen and 27 with the SWAP. The preoperative data are shown in Table 1. There was no significant difference in age at diagnosis or age at surgery between the 2 groups. The incidence of Down's syndrome, long-segment aganglionosis, and preoperative HEC did not differ. There were significantly more males in the LapSwen group. Eight patients required a preoperative stoma because of inadequate decompression with rectal
Discussion
There have been tremendous improvements in understanding HD, but HEC still remains a major source of morbidity. The proposed causes include obstruction, infection, alterations in intestinal mucous, diminished enterocyte adherence, alterations in intestinal immunocytes, and intestinal neuronal dysplasia [8]. The clinical diagnosis of HEC is based on signs and symptoms, with a spectrum of presentation from mild episodes of abdominal distension and explosive diarrhea to fulminant shock [1], [8].
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2011, Journal of InfectionCitation Excerpt :Of note are some studies refuting the link between C. difficile and antibiotic associated diarrhoea.39–41 C. difficile infection (CDI) is also becoming increasingly recognised as a significant co-morbid factor in prominent paediatric inpatient populations such as oncology42–45 and patients with gastrointestinal disorders such as Hirschsprung’s disease11,12,46–48 and inflammatory bowel disease (IBD).49,50 Furthermore, contact with infants aged <2 years has been linked with CDI in adults (14% versus 2%; P < 0.02) with community acquired disease.51