Investigating the Diagnostic and Risk Factors for Enterocolitis in Children with Hirschsprung’s Disease

Abstract Aim This study aimed to identify the clinical risk factors associated with Hirschsprung-associated enterocolitis (HAEC) in children with Hirschsprung’s disease (HD). Method A total of 75 children diagnosed with HD were recruited in this observational prospective study. Then, the clinical and paraclinical symptoms of children with Hirschsprung’s disease (n = 57) were compared to those with HAEC (n = 18). P-value < 0.05 was considered statistically significant. Results No significant difference was found between the two groups in terms of age (P = 0.72), gender (P = 0.51), and family history of HD (P = 0.25). Also, no significant difference in the rates of diarrhea (P = 0.59) and colicky pain (P = 0.99) was observed between the two groups. However, the rates of abdominal distension (P = 0.02) and lethargy (P = 0.01) were significantly higher among children with HAEC. Moreover, the incidence rates of dilated loops of bowel (P = 0.001), rectosigmoid cut-off sign (P = 0.01) and sepsis (P = 0.001) were significantly higher in the HAEC group than in patients with HD. The incidence of pneumoperitoneum was higher in HAEC patients (11.1% vs 5.3% in patients with HD), but not significantly so (P = 0.58). Moreover, no significant difference was found between the two groups in terms of leukocytosis (P = 0.46) and the incidence of short and/or long-segment colon aganglionosis (P = 0.65). Conclusion Clinical symptoms of abdominal distension, dilated loops of bowel, lethargy, sepsis, and pneumoperitoneum as well as the rectosigmoid cut-off sign on the CT-scanogram may specifically indicate and differentiate HAEC in children with Hirschsprung’s disease, which should be promptly diagnosed and treated.