From
StayCurrentMD
Update Course Rewind 2025: Botox for Hirschsprung’s: Where, When, and Why
With Dr. Lei Wen · hosted by Dr. Jill Knepprath
Chapter 1 of 5 · Fundamentals
Introduction and Topic Overview
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Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
50% of polled surgeons would not inject Botox at the same time as pull-through procedure
The Cincinnati Children's group injects Botox at the same time of surgery
Cincinnati Children's study from 2020 to 2024 found decreased risk of enterocolitis within 31 days after pull-through procedure: 0% versus 30%
There is no evidence on the number of units of Botox to use
Better data is needed on Botox dosing
Ultrasound guidance allows visualization of every layer, needle position, injection amount and location, and diffusion pattern
A 2022 multi-center study found that 24% of patients undergoing pull-through procedure also received Botox
Patients that received Botox had a higher chance of diaper rash
Injecting Botox during pull-through procedure for Hirschsprung's disease has been shown to reduce enterocolitis risk
Dosing and guidance for Botox injection varies widely