Guidelines for the management of postoperative soiling in children with Hirschsprung disease
Although most children with Hirschsprung disease ultimately achieve functional and comfortable stooling, some will experience a variety of problems after pull-through surgery. The most common problems include soiling, obstructive symptoms, enterocolitis, and failure to thrive. The purpose of this gu...
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| Veröffentlicht in: | Pediatric surgery international 2019-08, Vol.35 (8), p.829-834 |
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| container_title | Pediatric surgery international |
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| creator | Saadai, P. Trappey, A. F. Goldstein, A. M. Cowles, R. A. De La Torre, L. Durham, M. M. Huang, E. Y. Levitt, M. A. Rialon, K. Rollins, M. Rothstein, D. H. Langer, J. C. |
| description | Although most children with Hirschsprung disease ultimately achieve functional and comfortable stooling, some will experience a variety of problems after pull-through surgery. The most common problems include soiling, obstructive symptoms, enterocolitis, and failure to thrive. The purpose of this guideline is to present a rational approach to the management of postoperative soiling in children with Hirschsprung disease. The American Pediatric Surgical Association Hirschsprung Disease Interest Group engaged in a literature review and group discussions. Expert consensus was then used to summarize the current state of knowledge regarding causes, methods of diagnosis, and treatment approaches to children with soiling symptoms following pull-through for Hirschsprung disease. Causes of soiling after pull-through are broadly categorized as abnormalities in sensation, abnormalities in sphincter control, and “pseudo-incontinence.” A stepwise algorithm for the diagnosis and management of soiling after a pull-through for Hirschsprung disease is presented; it is our hope that this rational approach will facilitate treatment and optimize outcomes. |
| doi_str_mv | 10.1007/s00383-019-04497-y |
| format | Article |
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F. ; Goldstein, A. M. ; Cowles, R. A. ; De La Torre, L. ; Durham, M. M. ; Huang, E. Y. ; Levitt, M. A. ; Rialon, K. ; Rollins, M. ; Rothstein, D. H. ; Langer, J. C.</creator><creatorcontrib>Saadai, P. ; Trappey, A. F. ; Goldstein, A. M. ; Cowles, R. A. ; De La Torre, L. ; Durham, M. M. ; Huang, E. Y. ; Levitt, M. A. ; Rialon, K. ; Rollins, M. ; Rothstein, D. H. ; Langer, J. C. ; American Pediatric Surgical Association Hirschsprung Disease Interest Group ; The American Pediatric Surgical Association Hirschsprung Disease Interest Group</creatorcontrib><description>Although most children with Hirschsprung disease ultimately achieve functional and comfortable stooling, some will experience a variety of problems after pull-through surgery. The most common problems include soiling, obstructive symptoms, enterocolitis, and failure to thrive. The purpose of this guideline is to present a rational approach to the management of postoperative soiling in children with Hirschsprung disease. The American Pediatric Surgical Association Hirschsprung Disease Interest Group engaged in a literature review and group discussions. Expert consensus was then used to summarize the current state of knowledge regarding causes, methods of diagnosis, and treatment approaches to children with soiling symptoms following pull-through for Hirschsprung disease. Causes of soiling after pull-through are broadly categorized as abnormalities in sensation, abnormalities in sphincter control, and “pseudo-incontinence.” A stepwise algorithm for the diagnosis and management of soiling after a pull-through for Hirschsprung disease is presented; it is our hope that this rational approach will facilitate treatment and optimize outcomes.</description><identifier>ISSN: 0179-0358</identifier><identifier>EISSN: 1437-9813</identifier><identifier>DOI: 10.1007/s00383-019-04497-y</identifier><identifier>PMID: 31201486</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Algorithms ; Child ; Children & youth ; Colon ; Digestive System Surgical Procedures - methods ; Fecal incontinence ; Fecal Incontinence - etiology ; Fecal Incontinence - surgery ; Feces ; Hirschsprung Disease - complications ; Hirschsprung Disease - surgery ; Hospitals ; Humans ; Medicine ; Medicine & Public Health ; Motility ; Pediatric Surgery ; Pediatrics ; Postoperative Complications - prevention & control ; Postoperative Period ; Practice Guidelines as Topic ; Review Article ; Surgery ; Thoracic surgery ; Treatment Outcome</subject><ispartof>Pediatric surgery international, 2019-08, Vol.35 (8), p.829-834</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2019</rights><rights>Pediatric Surgery International is a copyright of Springer, (2019). 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C.</creatorcontrib><creatorcontrib>American Pediatric Surgical Association Hirschsprung Disease Interest Group</creatorcontrib><creatorcontrib>The American Pediatric Surgical Association Hirschsprung Disease Interest Group</creatorcontrib><title>Guidelines for the management of postoperative soiling in children with Hirschsprung disease</title><title>Pediatric surgery international</title><addtitle>Pediatr Surg Int</addtitle><addtitle>Pediatr Surg Int</addtitle><description>Although most children with Hirschsprung disease ultimately achieve functional and comfortable stooling, some will experience a variety of problems after pull-through surgery. The most common problems include soiling, obstructive symptoms, enterocolitis, and failure to thrive. The purpose of this guideline is to present a rational approach to the management of postoperative soiling in children with Hirschsprung disease. The American Pediatric Surgical Association Hirschsprung Disease Interest Group engaged in a literature review and group discussions. Expert consensus was then used to summarize the current state of knowledge regarding causes, methods of diagnosis, and treatment approaches to children with soiling symptoms following pull-through for Hirschsprung disease. Causes of soiling after pull-through are broadly categorized as abnormalities in sensation, abnormalities in sphincter control, and “pseudo-incontinence.” A stepwise algorithm for the diagnosis and management of soiling after a pull-through for Hirschsprung disease is presented; it is our hope that this rational approach will facilitate treatment and optimize outcomes.</description><subject>Algorithms</subject><subject>Child</subject><subject>Children & youth</subject><subject>Colon</subject><subject>Digestive System Surgical Procedures - methods</subject><subject>Fecal incontinence</subject><subject>Fecal Incontinence - etiology</subject><subject>Fecal Incontinence - surgery</subject><subject>Feces</subject><subject>Hirschsprung Disease - complications</subject><subject>Hirschsprung Disease - surgery</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Motility</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>Postoperative Complications - prevention & control</subject><subject>Postoperative Period</subject><subject>Practice Guidelines as Topic</subject><subject>Review Article</subject><subject>Surgery</subject><subject>Thoracic surgery</subject><subject>Treatment Outcome</subject><issn>0179-0358</issn><issn>1437-9813</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kD1PwzAQhi0EglL4AwzIEgtLwB_5sEdUQYtUiQU2JMtxLq1REgc7AfXfY2gBiYHphnvuvVcPQmeUXFFCiutACBc8IVQmJE1lkWz20ISmvEikoHwfTQgt4opn4ggdh_BCCBE8l4foiFNGaCryCXqej7aCxnYQcO08HtaAW93pFbTQDdjVuHdhcD14Pdg3wMHZCK-w7bBZ26by0OF3O6zxwvpg1qH3Y9xWNoAOcIIOat0EON3NKXq6u32cLZLlw_x-drNMDC-yISmqHERsJvIaiNAlY1JCxkpjCspSBlWaAWTUUM6M0DqttZBamLwEWdK6oHyKLre5vXevI4RBtTYYaBrdgRuDYiyjuWSZ5BG9-IO-uNF3sV2kuJR5bJRGim0p410IHmrVe9tqv1GUqE_3auteRffqy73axKPzXfRYtlD9nHzLjgDfAtFSdAj-9_c_sR8AJpC9</recordid><startdate>20190801</startdate><enddate>20190801</enddate><creator>Saadai, P.</creator><creator>Trappey, A. 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| source | MEDLINE; SpringerLink Journals |
| subjects | Algorithms Child Children & youth Colon Digestive System Surgical Procedures - methods Fecal incontinence Fecal Incontinence - etiology Fecal Incontinence - surgery Feces Hirschsprung Disease - complications Hirschsprung Disease - surgery Hospitals Humans Medicine Medicine & Public Health Motility Pediatric Surgery Pediatrics Postoperative Complications - prevention & control Postoperative Period Practice Guidelines as Topic Review Article Surgery Thoracic surgery Treatment Outcome |
| title | Guidelines for the management of postoperative soiling in children with Hirschsprung disease |
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