Hirschsprung Post Pull-thru algorithm

In brief

Clinical algorithm for evaluating and managing complications in pediatric patients with poor outcomes following Hirschsprung disease pull-through surgery. Guides systematic assessment of postoperative issues including enterocolitis, obstruction, and functional problems.

• Systematic evaluation of post-pull-through complications requires assessment of stooling pattern, continence, and enterocolitis signs
• Contrast enema and rectal biopsy help identify mechanical obstruction, stricture, or residual aganglionosis
• Anorectal manometry evaluates sphincter function and recto-anal inhibitory reflex in symptomatic patients
• Treatment options range from conservative management (dilations, bowel regimen) to surgical revision depending on etiology

Written by the GCMD Library team from the guideline.