Long-term stooling patterns in infants undergoing primary endorectal pull-through for Hirschsprung's disease. 1997

D H Teitelbaum, and R A Drongowski, and J N Chamberlain, and A G Coran
University of Michigan Medical Center and the C.S. Mott Children's Hospital, Ann Arbor 48109, USA.

Primary endorectal pull-through (ERPT) has become an increasingly popular method of caring for neonates and young infants who have Hirschsprung's disease. This study evaluated the long-term stooling patterns and continence rates of patients who had a primary ERPT as a young infant. The records of 24 infants who underwent a primary ERPT for Hirschsprung's disease were reviewed. The patients' families (those patients over 3 years of age, n = 12) underwent a detailed interview that graded continence from 0 (poor) to 10 (normal). Mean age at ERPT was 15 +/- 17 days (range, 2 to 67). Mean follow-up was 1,036 +/- 614 days. Nine patients suffered from 20 episodes of enterocolitis. Stooling frequency declined rapidly in the first 6 months after the ERPT (r2 = 1.00) and more slowly after this time (r2 = 0.79). Continence was graded as normal (10) in one, good (6 to 9 points) in nine, and fair (1 to 5) in two patients, both of whom had total colonic disease. The authors conclude that a primary ERPT in the young infant who has Hirschsprung's disease can yield excellent results including normalization of stooling frequency and good to excellent levels of continence.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011184 Postoperative Period The period following a surgical operation. Period, Postoperative,Periods, Postoperative,Postoperative Periods
D012007 Rectum The distal segment of the LARGE INTESTINE, between the SIGMOID COLON and the ANAL CANAL. Rectums
D003248 Constipation Infrequent or difficult evacuation of FECES. These symptoms are associated with a variety of causes, including low DIETARY FIBER intake, emotional or nervous disturbances, systemic and structural disorders, drug-induced aggravation, and infections. Colonic Inertia,Dyschezia
D003672 Defecation The normal process of elimination of fecal material from the RECTUM. Bowel Function,Bowel Movement,Bowel Functions,Bowel Movements,Defecations
D004760 Enterocolitis Inflammation of the MUCOSA of both the SMALL INTESTINE and the LARGE INTESTINE. Etiology includes ISCHEMIA, infections, allergic, and immune responses. Enterocolitides
D005242 Fecal Incontinence Failure of voluntary control of the anal sphincters, with involuntary passage of feces and flatus. Bowel Incontinence,Fecal Soiling,Incontinence, Bowel,Incontinence, Fecal,Soilings, Fecal
D006627 Hirschsprung Disease Congenital MEGACOLON resulting from the absence of ganglion cells (aganglionosis) in a distal segment of the LARGE INTESTINE. The aganglionic segment is permanently contracted thus causing dilatation proximal to it. In most cases, the aganglionic segment is within the RECTUM and SIGMOID COLON. Aganglionosis, Colonic,Colonic Aganglionosis,Megacolon, Congenital,Aganglionic Megacolon,Aganglionosis, Rectosigmoid Colon,Aganglionosis, Total Colonic,Congenital Intestinal Aganglionosis,Congenital Megacolon,Hirschsprung's Disease,Megacolon, Aganglionic,Rectosigmoid Aganglionosis,Total Colonic Aganglionosis,Aganglionosis, Rectosigmoid,Disease, Hirschsprung,Disease, Hirschsprung's,Hirschsprungs Disease,Rectosigmoid Colon Aganglionosis

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