MANAGEMENT OF HIRSCHSPRUNGS-DISEASE - AN ALTERNATE APPROACH

Management of neonatal Hirschsprung's disease based on diagnosis by hi stologic techniques and frozen section biopsy during colostomy is curr ently the most acceptable method. However, the non-availability of his tologic and histochemical techniques often necessitates alternate appr oaches. In 376 infants below the age of 2 months who were admitted wit h the presumptive diagnosis of Hirschsprung's disease, a barium enema was the key investigation. Histologic confirmation could be obtained a fter a colostomy was established. Manometry allowed the detection of a ny diagnostic errors. The overall error rate was approximately 4%. An alternate algorithm is suggested for the management of Hirschsprung's Disease, particularly in less well-developed centers.