Hirschisprung’s disease: Factors Affecting the Outcome at The National Ribat University Hospital, Khartoum, Sudan, 2007 to 2011

Abstract

Background: Hirschsprung's disease (HSD) remains the most frequent cause of child intestinal obstruction.
Objectives: to evaluate the effect of different factors at the final outcome, postoperative complications and the hospital stay of children with HSD.
Methodology: It is a retro-prospective analytical observational hospital based study, involving all the cases presented initially to the Paediatric Surgery Centre at the National Ribat University Hospital and confirmed to be a case of HSD. The data were collected using a questionnaire and analyzed by the software SPSS version 17.
Results: Sixty four patients were involved in this study with male to female ratio of 5:1. The mean age at the first time of presentation was 9 days and the bulk of the patients seen from the center of Sudan. The emergency presentation accounted for 21.9% of the cases with the delayed passage of
meconium and constipation as the main presenting symptoms. Complications occur mainly at day 13 post operatively with colostomy prolapse as the commonest type of complications. The age of the patients at the time of Pull Through Procedure (PTP) was ranging between 7 to 72 months and the mean body weight found to be 11.94 kg. Complications
following PTP occur in 18.8% of the cases, with wound infection accounting for 15.6% of the cases. The total duration of hospital stay post operatively after reversal of colostomy was found to range between 6 and 60 days with a mean of 8.77 days and SD of ± 6.657.
Conclusion: The average hospital frequency of HSD in our study is  compared to that encountered in European countries and Northern  American countries. Early diagnosis and treatment is essential for better outcome. Emergency presentation, age and the weight at Pull Through Operation and at the time of closure of colostomy, significantly affect the outcome and prolong the hospital stay.

Key words: Hirschsprung's Disease, colostomy, Pull Through Operation.