title: The Hirschsprungs patient who is soiling after what was considered a "successful" pull-through.
abstract: After surgery for Hirschsprungs disease, most children thrive, have few if any episodes of abdominal distention and enterocolitis, and are fecally continent. However, there exists a small group of patients who do not do well. Either they suffer from persistent distension and enterocolitis or they experience soiling after their pull-through procedure. These patients can be systematically evaluated and successfully treated with a combination of bowel management, dietary changes, and laxatives, and, in certain circumstances, a reoperation.
authors.affiliation: Colorectal Center for Children, Cincinnati Children's Hospital Medical Center, Division of Pediatric Surgery, Department of Surgery, University of Cincinnati, Cincinnati, OH 45229, USA. marc.levitt@cchmc.org
authors.forename: Marc A
authors.initials: MA
authors.lastname: Levitt
authors.forename: Belinda
authors.initials: B
authors.lastname: Dickie
authors.forename: Alberto
authors.initials: A
authors.lastname: Peña
mesh_terms: D000465:Algorithms; D001003:Anal Canal / Q000503:physiopathology / Q000601:surgery; D000714:Anastomosis, Surgical; D003082:Colectomy; D003106:Colon / Q000601:surgery; D003131:Combined Modality Therapy; D003661:Decision Support Techniques; D005242:Fecal Incontinence / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006627:Hirschsprung Disease / Q000601:surgery*; D006801:Humans; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D012007:Rectum / Q000601:surgery; D016896:Treatment Outcome