Guidelines for the management of postoperative soiling in children with Hirschsprung disease
link.springer.com shows its articles on its own site.
Read the article on link.springer.com ↗Article · Aug 2019 · 1 min read
In brief
In brief
This consensus guideline from the American Pediatric Surgical Association addresses postoperative soiling in children after Hirschsprung disease pull-through surgery. It categorizes causes into sensation abnormalities, sphincter control issues, and pseudo-incontinence, providing a stepwise diagnostic and management algorithm to optimize outcomes.
Written by the GCMD Library team from the article.
Abstract
Although most children with Hirschsprung disease ultimately achieve functional and comfortable stooling, some will experience a variety of problems after pull-through surgery. The most common problems include soiling, obstructive symptoms, enterocolitis, and failure to thrive. The purpose of this guideline is to present a rational approach to the management of postoperative soiling in children with Hirschsprung disease. The American Pediatric Surgical Association Hirschsprung Disease Interest Group engaged in a literature review and group discussions. Expert consensus was then used to summarize the current state of knowledge regarding causes, methods of diagnosis, and treatment approaches to children with soiling symptoms following pull-through for Hirschsprung disease. Causes of soiling after pull-through are broadly categorized as abnormalities in sensation, abnormalities in sphincter control, and “pseudo-incontinence.” A stepwise algorithm for the diagnosis and management of soiling after a pull-through for Hirschsprung disease is presented; it is our hope that this rational approach will facilitate treatment and optimize outcomes.