Pediatric Hirschsprung Disease Follow-up

Updated: Aug 09, 2016
  • Author: Holly L Neville, MD; Chief Editor: Carmen Cuffari, MD  more...
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Follow-up

Further Outpatient Care

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  • Prior to surgical intervention in patients with Hirschsprung disease, perform close follow-up care to be sure the colon is adequately decompressed and that signs or symptoms of enterocolitis do not develop. Teach the family techniques of decompression and rectal irrigation because these therapies aid in decreasing colonic dilation in preparation for surgery.
  • Preoperatively, counsel the family as to the available surgical options. If the child is to undergo a staged procedure or have a permanent ostomy, provide preliminary instruction about ostomy care to the family.
  • Postoperatively, patients need close follow-up care to assess healing as well as a screen for potential complications (eg, stricture formation). Outpatient dilations may be necessary to alleviate strictures and should be expected in patients who undergo a single-stage pull-through procedure in the newborn period.
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Complications

Postoperative complications may include intermittent fecal soiling and incontinence, anastomotic leak, stricture formation, intestinal obstruction, and enterocolitis.

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Prognosis

The outcome in infants and children with Hirschsprung disease is generally quite good. Most children obtain fecal continence and control. However, children with other significant comorbidities, such as major genetic abnormalities, may have lower rates of continence.

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Patient Education

Alert patients and their families to potential preoperative and postoperative complications of Hirschsprung disease. When applicable, teach patients and their families how to care for an ostomy.

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