Enterocolitis associated with Hirschsprung's disease: A clinical-radiological characterization based on 168 patients

Elhalaby, Essam A.; Coran, Arnold G.; Blane, Caroline E.; Hirschl, Ronald B.; Teitelbaum, Daniel H.

doi:10.1016/0022-3468(95)90615-0

Cited by 159 publications

(86 citation statements)

References 40 publications

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“…The incidence of clinical episodes of postoperative enterocolitis was also examined. Severity of enterocolitis was stratified into three grades according to a clinical grading system established by Elhalaby et al [14] as follows: grade 1, mild explosive diarrhea, mild to moderate abdominal distension, no systemic manifestations; grade 2, moderately explosive diarrhea, moderate to severe abdominal distension associated with systemic manifestations such as fever and tachycardia; grade 3, explosive diarrhea, marked abdominal distension, shock.…”

Section: Methodsmentioning

confidence: 99%

Prospective analysis of primary modified Georgeson’s laparoscopy-assisted endorectal pull-through for Hirschsprung’s disease: short- to mid-term results

et al. 2005

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The aim of this study was to analyze the short- to mid-term outcome of primary modified Georgeson's laparoscopy-assisted endorectal pull-through (PMGLEPT) for Hirschsprung's disease (HD). HD patients treated by PMGLEPT were evaluated prospectively by a single surgeon using a standard structured questionnaire to assess complications, incidence of enterocolitis, and evaluate continence (CE). CE involved scoring five parameters (frequency of motions, severity of staining/soiling, severity of perianal erosions, anal shape, and requirement for medications) on a 3-point scale (0, 1, and 2 for each parameter). Thus, scores for CE were: 10 = normal, 8-9 = good, 6-7 = fair, and 0-5 = poor. Our modifications include transanal rectal dissection starting below or on the dentate line, near total excision of the posterior rectal cuff, and intraoperative acetylcholinesterase staining to accurately identify normal colon. Patients with total colon aganglionosis or trisomy-21 were excluded, leaving 33 cases of PMGLEPT performed between 1997 and 2004. Mean operative age was 11.0 months. Follow-up ranged from 8 months to 7 years (mean 4.0 years). There were no intraoperative complications. Post-PMGLEP, bowel obstruction occurred in 1 subject who required middle colic division for pull-through (PT), and enterocolitis occurred in 3 (9.1%) of 33 patients. In 20 subjects aged over 3 years with a follow-up period of more than 12 months, final CE was normal in 5, good in 10, fair in 4, and poor in 1, despite staining/soiling being present in 12 (60%) of 20 subjects. None of the 33 had constipation. Our results suggest that PMGLEPT is safe with acceptable outcome in the short- to mid-term. However, careful long-term follow-up is mandatory as there appears to be a relatively high incidence of staining/soiling on short- to mid-term follow-up.

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Section: Methodsmentioning

confidence: 99%

Prospective analysis of primary modified Georgeson’s laparoscopy-assisted endorectal pull-through for Hirschsprung’s disease: short- to mid-term results

et al. 2005

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“…We defined an episode of enterocolitis as explosive diarrhea or abdominal distension requiring hospitalization for hydration and antibiotics. 8 …”

Section: Methodsmentioning

confidence: 99%

Long-term follow-up of redo pull-through procedures for Hirschsprung's disease: Efficacy of the endorectal pull-through

Leeuwen

Teitelbaum

Elhalaby

et al. 2000

Journal of Pediatric Surgery

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“…Le tableau clinique peut être très variable: (1) occlusion intestinale néonatale (iléale) parfois incomplète avec ou sans évacuation spontanée de méconium, et des signes cliniques, tels qu'une radiographie, pourraient aider à diagnostiquer un iléus méconial; (2) entérocolite néonatale [31,32] , qui pourrait être liée à la maladie de Hirschsprung étendue en l'absence de prématurité ou de cardiopathie sévère; (3) présentation aiguë avec perforation appendiculaire ou caecale [33] , et (4) constipation sévère Une entérocolite [34] peut être considérée comme une septicémie d'origine intestinale, secondaire à une prolifération microbienne endoluminale induite par une stase associée à une ulcération de la paroi intestinale et à une ischémie par distension. Au plan clinique, l'enfant pré-sente une distension abdominale douloureuse majeure et un sepsis profond.…”

Section: Présentation Cliniqueunclassified

Diagnostic de la constipation chez l’enfant

Sauvat¹

2007

Ann Nestlé [Fr]

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La constipation est un motif fréquent de consultation d’un pédiatre. A titre de symptôme, une constipation peut être due à des etiologies diverses en termes de fréquence, de nature et de gravité. La constipation peut être d’origine médicale ou chirurgicale, ou idiopathique. Les étiologies chirurgicales sont principalement représentées par la maladie de Hirschsprung. Il s’agit du principal diagnostic différentiel même s’il est 50 fois moins fréquent que la constipation idiopathique ou fonctionnelle. Une anamnèse détaillée et un examen clinique, incluant un examen anal, sont les meilleurs moyens de parvenir à un diagnostic. Aucun autre examen n’est nécessaire dans la plupart des cas et toutes les explorations doivent être gérées en fonction des considérations cliniques.

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Enterocolitis associated with Hirschsprung's disease: A clinical-radiological characterization based on 168 patients

Cited by 159 publications

References 40 publications

Prospective analysis of primary modified Georgeson’s laparoscopy-assisted endorectal pull-through for Hirschsprung’s disease: short- to mid-term results

Prospective analysis of primary modified Georgeson’s laparoscopy-assisted endorectal pull-through for Hirschsprung’s disease: short- to mid-term results

Long-term follow-up of redo pull-through procedures for Hirschsprung's disease: Efficacy of the endorectal pull-through

Diagnostic de la constipation chez l’enfant

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