Clinical Profile of Hirschsprung Disease, Postoperative Complications of Modified Duhamel Procedure and their Management

Hirschsprung disease (HD) is a congenital condition marked by the absence of ganglion cells in the distal bowel, causing chronic intestinal obstruction. The modified Duhamel procedure is a widely used surgical approach to treat HD, aiming to restore bowel function by creating a neorectum. This study aimed to evaluate the clinical profile of patients with HD and analyze the postoperative complications associated with the modified Duhamel procedure, as well as their management. A Prospective retrospective review was conducted on pediatric patients diagnosed with HD who underwent the modified Duhamel procedure. Data such as age, gender, and presenting symptoms were collected, along with details of postoperative complications including anastomotic stricture, enterocolitis, and faecal incontinence. Management strategies like reoperation, dilation, and medical therapy were also reviewed. The study included 8 patients with an average age of neonate to 13 years. Out of 8 patients, 5 (62.5) were males and 3 (37.5) were females. All patients were analysed for early postoperative complications, with decreased appetite observed in 12.5 of the cases, skin irritation and erythema in 37.5, postoperative fever in 12.5, stoma prolapse in 12.5, and wound infection in 12.5. Late complications included subacute intestinal obstruction (12.5), deranged electrolytes (12.5), and postoperative septicaemia leading to death in 12.5 of the patients. Early intervention with balloon dilatation effectively treated anastomotic strictures, while antibiotic therapy was successfully used for enterocolitis management. A few cases required reoperation due to severe complications. The results highlight that while the modified Duhamel procedure is effective in managing HD, postoperative complications are not uncommon and can significantly impact recovery. Early identification and appropriate management of these complications, particularly through non-surgical interventions, are key to achieving favourable outcomes and improving the quality of life for pediatric patients with HD.