Abstract:

Objective To investigate non-surgical risk factors for recurrent Hirschsprung-associated enterocolitis (HAEC). Methods A retrospective analysis was conducted on clinical data of 67 cases with Hirschsprungs disease (HD) treated by the radical operation between January 2007 and January 2014 at Shanghai Childrens Medical Center affiliated to Shanghai Jiao Tong University School of Medicine. Patients suffered 3 or more episodes of enterocolitis were assigned to the recurrent HAEC group (HAEC-R group). Patients with 1 or 2 episodes were assigned to the HAEC group. Patients without enterocolitis were assigned to the control group. The non-surgical risk factors for recurrent HAEC were analyzed. Results Gender and age at radical surgery had no statistical differences among three groups (P>0.05). Clinical types of HD and the incidence of hypoalbuminemia had no statistical differences between the HAEC-R group and the HAEC group (P>0.05), but had significant statistical differences between the HAEC-R group and the control group (P<0.05). The differences in the incidences of preoperative malnutrition, enterocolitis, upper respiratory tract infection, and pneumonia between the HAEC-R group and the HAEC group were statistically significant (P<0.05) and the differences between the HAEC group and the control group were not statistically significant (P>0.05). The multivariate logistic regression analysis showed that preoperative malnutrition and enterocolitis were independent risk factors for recurrent HAEC (OR=9.000, 95%CI=1.355-59.783; OR=8.667, 95%CI=1.526-49.220). Conclusion The preoperative malnutrition and enterocolitis may be risk factors for recurrent HAEC.

Key words: Hirschsprung’s disease, enterocolitis, recurrence, risk factor