Update Course Rewind 2025: Hirschsprung’s Pull-Through: Why Family Training May Save Lives

Suction rectal biopsy is diagnostic for Hirschsprung's disease

There is not really evidence in the literature of good timing to perform a pull-through procedure

A 2021 PCPLC retrospective study compared outcomes of neonatal pull-through versus delayed primary pull-through

The median age of the neonatal group was 11 days at time of surgery

The median age of the delayed group was 98 days at time of surgery

The study found no difference in preoperative and postoperative enterocolitis between neonatal and delayed pull-through groups

The study found no difference in fecal incontinence at follow-up between neonatal and delayed pull-through groups

Family ability to perform irrigations at home is an important skill

A family who is really good at irrigations will save a baby's life

Kids whose families cannot perform adequate washouts may not be able to go home

Inadequate decompression can lead to hospitalization with colitis or perforation

Studies show no difference in complications between neonatal and delayed pull-through procedures for Hirschsprung patients

Decisions on timing should factor in the family's ability to perform irrigations