Late diagnosis of Hirschsprung disease--patient characteristics and results.
OBJECTIVE
The aim of the present study was to describe the characteristics and the postoperative results of children diagnosed as having Hirschsprung disease (HD) after the age of 3 years.


METHODS
All patients with HD diagnosed after the age of 3 years in our hospital from 1998 to 2011 were included. Patient characteristics and postoperative results were prospectively registered.


RESULTS
Eleven children were included. Age at diagnosis was 3.0 to 9.6 years. Ten patients had rectosigmoid disease, whereas 1 had total colonic aganglionosis. Three children were given a diverting ileostomy before the pull-through procedure, and all 3 had ileostomy-related complications. Early postoperative complications were seen in 5 children, of whom 2 had anastomotic leakage. At final follow-up, with a median of 3 years postoperatively, 7 had normal bowel function, 1 had frequent loose stools, and 3 were soiling.


CONCLUSIONS
Early postoperative complications, especially anastomotic leakage, occurred frequently in children with late-diagnosed HD. Therefore, a diverting stoma should be considered in these patients. The long-term functional results were comparable with those seen in children operated on as neonates.
Department of Paediatric Surgery, Oslo University Hospital, Oslo, Norway. kstensru@ous-hf.no
Kjetil Juul
KJ
Stensrud
Ragnhild
R
Emblem
Kristin
K
Bjørnland
D002675:Child, Preschool; D057210:Delayed Diagnosis; D006627:Hirschsprung Disease / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D011446:Prospective Studies; D016896:Treatment Outcome