Error Traps and Culture of Safety in Hirschsprung Disease

The June issue of Seminars in Pediatric Surgery focused on a topic that's important to every pediatric surgeon, improving the health care we deliver to children around the world. Follow along with our latest video series as we highlight articles that help enhance the culture of safety in various pediatric surgical subspecialties. And you might recognize a few well-known faces and names along the way. Here's a quick summary of error traps and culture of safety in Hirshprung disease. With guest video reviewer, Dr. Louis Delatorre. Many errors still happen in patients with Hirshprung, resulting in complications and mortality. The most common error in these patients are the false diagnosis of Hirshprung because of an inadequate biopsy. The incorrect performance of rectal irrigations during the medical treatment of this condition. The failure to demonstrate the transitional zone in the contrast enema. The problematic intraoperative diagnosis of transitional zone. Damage of the anal canal and mapping the colon with multiple biopsies in the patient with low intestinal obstruction, missing the rectal biopsy to confirm Hirshprung disease. These errors are the source of pull-throughs in patients with idiopathic constipation, multiple bowel resection with loss of significant amount of colon, fecal incontinence, and the necessity of colostomy or ileostomies. If we avoid these errors, we can improve the outcome and the quality of life of these patients.