Clinical Impacts of Delayed Diagnosis of Hirschsprung’s Disease in Newborn Infants
Asian infants are at a higher risk of having Hirschsprung’s disease (HD). Although HD is surgically correctable, serious and even lethal complications such as Hirschsprung’s-associated enterocolitis (HAEC) can still occur. The aim of this study was to investigate the risk factors of HAEC, and the cl...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2012-04-01
|
| Series: | Pediatrics and Neonatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957212000125 |
| _version_ | 1818479553625980928 |
|---|---|
| author | Chien-Chung Lee Reyin Lien Ming-Chou Chian Peng-Hong Yang Shih-Ming Chu Jen-Hei Fu Jin-Yao Lai |
| author_facet | Chien-Chung Lee Reyin Lien Ming-Chou Chian Peng-Hong Yang Shih-Ming Chu Jen-Hei Fu Jin-Yao Lai |
| author_sort | Chien-Chung Lee |
| collection | DOAJ |
| description | Asian infants are at a higher risk of having Hirschsprung’s disease (HD). Although HD is surgically correctable, serious and even lethal complications such as Hirschsprung’s-associated enterocolitis (HAEC) can still occur. The aim of this study was to investigate the risk factors of HAEC, and the clinical impacts of delayed diagnosis of HD in newborn infants.
Patients and methods: By review of medical charts in a medical center in Taiwan, 51 cases of neonates with HD between 2002 and 2009 were collected. Patients were divided into two groups based on the time of initial diagnosis: Group I, diagnosis made within 1 week after birth, and Group II after 1 week. Clinical features including demographic distribution, presenting features of HD, short-term and long-term complications related to HD were compared between the two groups of patients.
Results: There were 25 patients in Group I and 19 in Group II. Group II patients had more severe clinical signs and symptoms of HAEC than Group I patients. The incidence of preoperative HAEC was 12% in Group I and 63% in Group II (adjusted odds ratio = 12.81, confidence interval = 2.60–62.97). Patients with preoperative HAEC were more likely to develop adhesive bowel obstruction after operation (33% vs. 3%, p = 0.013) and failure to thrive (33% vs. 3%, p = 0.013). Also, patients with long-segment or total colonic aganglionosis were at risk of developing both postoperative HAEC (85% vs. 29%, p = 0.001) and failure to thrive (39% vs. 3%, p = 0.002).
Conclusion: In our study, we found that delayed diagnosis of HD beyond 1 week after birth significantly increases the risk of serious complications in neonatal patients. Patients with long-segment or total colonic aganglionosis have higher risk of postoperative HAEC and failure to thrive. Patients with preoperative HAEC are more likely to have adhesive bowel obstruction and failure to thrive. |
| first_indexed | 2024-12-10T11:12:16Z |
| format | Article |
| id | doaj.art-906117c80fd14e6b9c04ccaa96efa8ff |
| institution | Directory Open Access Journal |
| issn | 1875-9572 |
| language | English |
| last_indexed | 2024-12-10T11:12:16Z |
| publishDate | 2012-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj.art-906117c80fd14e6b9c04ccaa96efa8ff2022-12-22T01:51:22ZengElsevierPediatrics and Neonatology1875-95722012-04-0153213313710.1016/j.pedneo.2012.01.011Clinical Impacts of Delayed Diagnosis of Hirschsprung’s Disease in Newborn InfantsChien-Chung Lee0Reyin Lien1Ming-Chou Chian2Peng-Hong Yang3Shih-Ming Chu4Jen-Hei Fu5Jin-Yao Lai6Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taoyuan, TaiwanDivision of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taoyuan, TaiwanDivision of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taoyuan, TaiwanDivision of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taoyuan, TaiwanDivision of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taoyuan, TaiwanDivision of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taoyuan, TaiwanDivision of Neonatology, Department of Pediatric Surgery, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taoyuan, TaiwanAsian infants are at a higher risk of having Hirschsprung’s disease (HD). Although HD is surgically correctable, serious and even lethal complications such as Hirschsprung’s-associated enterocolitis (HAEC) can still occur. The aim of this study was to investigate the risk factors of HAEC, and the clinical impacts of delayed diagnosis of HD in newborn infants. Patients and methods: By review of medical charts in a medical center in Taiwan, 51 cases of neonates with HD between 2002 and 2009 were collected. Patients were divided into two groups based on the time of initial diagnosis: Group I, diagnosis made within 1 week after birth, and Group II after 1 week. Clinical features including demographic distribution, presenting features of HD, short-term and long-term complications related to HD were compared between the two groups of patients. Results: There were 25 patients in Group I and 19 in Group II. Group II patients had more severe clinical signs and symptoms of HAEC than Group I patients. The incidence of preoperative HAEC was 12% in Group I and 63% in Group II (adjusted odds ratio = 12.81, confidence interval = 2.60–62.97). Patients with preoperative HAEC were more likely to develop adhesive bowel obstruction after operation (33% vs. 3%, p = 0.013) and failure to thrive (33% vs. 3%, p = 0.013). Also, patients with long-segment or total colonic aganglionosis were at risk of developing both postoperative HAEC (85% vs. 29%, p = 0.001) and failure to thrive (39% vs. 3%, p = 0.002). Conclusion: In our study, we found that delayed diagnosis of HD beyond 1 week after birth significantly increases the risk of serious complications in neonatal patients. Patients with long-segment or total colonic aganglionosis have higher risk of postoperative HAEC and failure to thrive. Patients with preoperative HAEC are more likely to have adhesive bowel obstruction and failure to thrive.http://www.sciencedirect.com/science/article/pii/S1875957212000125delayed diagnosisenterocolitisHirschsprung’s diseaseneonate |
| spellingShingle | Chien-Chung Lee Reyin Lien Ming-Chou Chian Peng-Hong Yang Shih-Ming Chu Jen-Hei Fu Jin-Yao Lai Clinical Impacts of Delayed Diagnosis of Hirschsprung’s Disease in Newborn Infants Pediatrics and Neonatology delayed diagnosis enterocolitis Hirschsprung’s disease neonate |
| title | Clinical Impacts of Delayed Diagnosis of Hirschsprung’s Disease in Newborn Infants |
| title_full | Clinical Impacts of Delayed Diagnosis of Hirschsprung’s Disease in Newborn Infants |
| title_fullStr | Clinical Impacts of Delayed Diagnosis of Hirschsprung’s Disease in Newborn Infants |
| title_full_unstemmed | Clinical Impacts of Delayed Diagnosis of Hirschsprung’s Disease in Newborn Infants |
| title_short | Clinical Impacts of Delayed Diagnosis of Hirschsprung’s Disease in Newborn Infants |
| title_sort | clinical impacts of delayed diagnosis of hirschsprung s disease in newborn infants |
| topic | delayed diagnosis enterocolitis Hirschsprung’s disease neonate |
| url | http://www.sciencedirect.com/science/article/pii/S1875957212000125 |
| work_keys_str_mv | AT chienchunglee clinicalimpactsofdelayeddiagnosisofhirschsprungsdiseaseinnewborninfants AT reyinlien clinicalimpactsofdelayeddiagnosisofhirschsprungsdiseaseinnewborninfants AT mingchouchian clinicalimpactsofdelayeddiagnosisofhirschsprungsdiseaseinnewborninfants AT penghongyang clinicalimpactsofdelayeddiagnosisofhirschsprungsdiseaseinnewborninfants AT shihmingchu clinicalimpactsofdelayeddiagnosisofhirschsprungsdiseaseinnewborninfants AT jenheifu clinicalimpactsofdelayeddiagnosisofhirschsprungsdiseaseinnewborninfants AT jinyaolai clinicalimpactsofdelayeddiagnosisofhirschsprungsdiseaseinnewborninfants |