Enterocolitis Associated with Hirschsprung's Disease

Aka: Enterocolitis Associated with Hirschsprung's Disease, Hirschsprung-Related Enterocolitis

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II. Symptoms

  1. Early
    1. Abdominal Distention
    2. Foul-smelling watery stools
    3. Lethargy
    4. Failure to Thrive
  2. Late
    1. Emesis or Hematochezia
    2. Fever
    3. High mortality rate

III. Management

  1. Rectal irrigation 3-4 times daily
    1. Normal Saline infused in Rectum via Rubber catheter
    2. Insert in steps
      1. Total infused: 10-15 cc/kg
      2. Wait for 10-15 cc to leak out of Rectum
        1. Then insert cathetr further
  2. Mild cases
    1. Metronidazole
  3. Moderate to severe cases
    1. Broad spectrum IV antibiotics

IV. References

  1. Coran (2000) Am J Surg 180:382-7 [PubMed]

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