Publish in this journal
Journal Information
Vol. 88. Num. 6.01 June 2018
Pages 299-356
Share
Share
Download PDF
More article options
ePub
Visits
45
Vol. 88. Num. 6.01 June 2018
Pages 299-356
Original Article
DOI: 10.1016/j.anpede.2017.07.006
Hirschsprung-associated enterocolitis: Observational study in a paediatric emergency care unit
Enterocolitis asociada a enfermedad de Hirschsprung: estudio observacional sobre clínica y manejo en un servicio de urgencias hospitalarias
Visits
45
Margarita Sellersa,
Corresponding author
, Clara Udaondoa, Bárbara Morenoa, Gonzalo Martínez-Alésb, Jesús Díezb, Leopoldo Martínezc, María de Ceano-Vivasa
a Servicio de Urgencias Pediátricas, Hospital Infantil Universitario La Paz, Madrid, Spain
b Unidad de Investigación, Hospital Infantil Universitario La Paz, Madrid, Spain
c Servicio de Cirugía Pediátrica, Hospital Infantil Universitario La Paz, Madrid, Spain
This item has received
45
Visits
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Tables (3)
Table 1. Baseline characteristics of the sample.
Table 2. Clinical variables under study.
Table 3. Odds ratios obtained for the clinical variables under study.
Show moreShow less
Abstract
Introduction

Hirschsprung-associated enterocolitis is a significant cause of morbidity and mortality in infants with Hirschsprung's disease. The fact that the symptoms are so variable and unspecific leads to a slow or incorrect diagnosis. The purpose of this study is to identify clinical factors associated with the diagnosis, as well as to evaluate the subsequent management of children with suspected Hirschsprung-associated enterocolitis in a paediatric emergency department.

Material and methods

A retrospective descriptive study was conducted on patients with Hirschsprung's disease who were seen in a paediatric emergency department between April 2011 and November 2015 due to clinical symptoms compatible with enterocolitis. An analytical multivariate analysis was also performed on the epidemiological and clinical variables associated to enterocolitis.

Results

A total of 75 consultation episodes in the Paediatric Emergency Department were studied, of which 52% (39) were finally diagnosed as enterocolitis. Overall, diarrhoea was the most frequent reason for consultation (74.7%). Lethargy, abdominal distension, and pathological findings on the X-ray showed a significant association with the diagnosis of Hirschsprung-associated enterocolitis. Hospital admission rate was 77.3%.

Conclusion

Hirschsprung-associated enterocolitis should be considered in all children with Hirschsprung's disease that consult the Emergency Department, especially those with gastrointestinal symptoms associated with lethargy, abdominal distension and pathological findings on the X-ray. The therapeutic diagnostic process should be initiated as soon as possible, either by clinical observation, if there are any doubts, or by medical treatment if there is a high clinical suspicion.

Keywords:
Hirschsprung's disease
Enterocolitis
Child
Paediatrics
Risk factor
Resumen
Introducción

La enterocolitis asociada a la enfermedad de Hirschsprung es su complicación más grave y conlleva una importante morbimortalidad. Se presenta con síntomas inespecíficos que dificultan el diagnóstico. Este trabajo pretende identificar, en pacientes con clínica compatible que acuden a un servicio de urgencias pediátricas, los factores clínicos asociados a enterocolitis asociada a enfermedad de Hirschsprung y evaluar su manejo posterior.

Material y métodos

Estudio retrospectivo descriptivo de los pacientes con enfermedad de Hirschsprung que acudieron al Servicio de Urgencias Pediátricas entre abril de 2011 y noviembre de 2015 con clínica digestiva compatible con enterocolitis. Análisis uni y multivariante de las variables epidemiológicas y clínicas asociadas al riesgo de padecer enterocolitis.

Resultados

Se estudiaron un total de 75 episodios de consulta, de los que un 52% (39) fueron finalmente catalogados de enterocolitis. Globalmente, la diarrea fue el motivo de consulta más frecuente (74,7%). La presencia de letargia, distensión abdominal y alteraciones en la radiografía de abdomen demostró una asociación estadísticamente significativa con el diagnóstico de enterocolitis asociada a enfermedad de Hirschsprung. Se realizó ingreso hospitalario en el 77,3% de los casos.

Conclusión

La enterocolitis asociada a la enfermedad de Hirschsprung debe tenerse en cuenta en todos aquellos pacientes con enfermedad de Hirschsprung que consulten en Urgencias por síntomas digestivos, especialmente si asocian letargia, distensión abdominal o hallazgos patológicos en la radiografía de abdomen. Se debe iniciar el proceso diagnóstico-terapéutico precozmente, ya sea con observación clínica si existen dudas diagnósticas o con tratamiento médico si existe una alta sospecha clínica.

Palabras clave:
Enfermedad de Hirschsprung
Enterocolitis
Niño
Pediatría
Factores de riesgo

Article

These are the options to access the full texts of the publication Anales de Pediatría (English Edition)
Member
If you are a member of the Asociación Española de Pediatría:
Go to the members area of the website of the AEPED, (http://www.aeped.es/biblioteca )and login.

Next go to the journal


Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Idiomas
Anales de Pediatría (English Edition)

Subscribe to our Newsletter

Article options
Tools
Cookies policy
To improve our services and products, we use cookies (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.