Complications of Swenson’s Procedure in Hirschsprung’s Disease- A Hospital Based 5 Year Study

Abstract

BACKGROUND Hirschsprung's Disease (HD) is the commonest cause of functional intestinal obstruction in children and poses challenges to paediatricians and paediatric surgeons in resource-limited countries. This disease results from failure of ganglion cells to migrate cephalocaudally through the neural crest during 4 th to 12 th weeks of gestation, causing an absence of ganglion cells in all or part of the colon. This study describes the clinical characteristics and management of this disease in our setup and highlights the challenges associated with the care of such patients. METHODS This was a prospective observational study of children from neonatal age group up to 10 years who were histologically diagnosed and treated for HD at our institute between March 20013 and February 2018. RESULTS A total of 63 patients (M: F= 2.5: 1) with a median age of 3.2 months (IQR of 0.17-10.00 months) were studied. Almost all patients presented with intestinal obstruction followed by constipation in 93.65% cases. We did not encounter enterocolitis. All the patients underwent Swenson's definitive pull-through. Postoperative complications were very minimal. Mortality rate was 12.69%. During the follow-up period results of Swenson's procedure was found to be good. CONCLUSIONS HD is the commonest cause of functional intestinal obstruction in children and in older children presenting with constipation. This disease is associated with high morbidity and mortality especially in those older children who present late and when the dise ase becomes complicated. Early diagnosis and treatment are the cornerstones of the management of this malady. HOW TO CITE THIS ARTICLE: Mahanta K, Gogoi M. Complications of swenson's procedure in hirschsprung's disease-a hospital based 5 year study.