CLINICAL RISK-FACTORS OF HIRSCHSPRUNG-ASSOCIATED ENTEROCOLITIS .1. PREOPERATIVE ENTEROCOLITIS

Enterocolitis is still the main source of mortality and morbidity in H irschsprung's disease (HD). Between 1976 and 1993, 79 (26%) of 302 Hir schsprung patients proved to have Hirschsprung-associated enterocoliti s (HAEC). Mortality was 7.6 percent (6 patients). HAEC patients, those who died of HAEC and those without HAEC were analyzed (or differences in 34 parameters. The length of the aganglionic segment was found not to be a risk factor for HAEC, but early diagnosis and prompt treatmen t were found to decrease the occurrence of preoperative HAEC. Although we defined HAEC as foul smelling, explosive diarrhea, some other symp toms and signs, such as abdominal distention on physical examination, vomiting, dehydration, and a history of nonspecific diarrhea were enco untered with significant frequency. None of the patients had Down's sy ndrome. Sepsis was detected in all of the patients who died of HAEC. T he severity of HAEC did not increase with the number of attacks of HAE C, and mortality was greater in the first three attacks. Differences i n results between some series seemed to be related to differing defini tions of HAEC.