الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Any newborn with a distal intestinal obstruction or an older child with persistently severe constipation or enterocolitis should be evaluated for Hirschsprung disease.
HAEC can be presented by abdominal distention, bloody stool, intestinal perforation, sepsis, peritonitis, shock, and death. Children with HSD who get multiple attacks preoperatively have higher risks of developing HAEC postoperatively.
Different strategies were used to assess these patients including history taking, physical examination, barium studies, and frozen biopsies during surgical procedures.
The gold standard for diagnosis of HAEC is an appropriate rectal biopsy revealing aganglionosis, even though it might be suspected from the history, physical exam, and radiography.
During conservative management of patients with HSD, rectal tube irrigations play a big role in preventing progression to HAEC.
HAEC is treated by surgical methods and can also be treated conservatively as seen from our study.
While a stoma may still be necessary for infants with severe enterocolitis, malnutrition, significant colonic distension, insufficient pathology support, or long-segment disease, most children can be managed with a one-stage pull-through surgery.
The Swenson, Soave, and Duhamel procedures are among the most popular ones; the surgeon should do the technique for which he or she has received training and experience.
Compared to open surgeries, the laparoscopic and transanal methods are associated with reduced pain, quicker feeding, and shorter hospital stays.
Before starting the anal dissection during a laparoscopic or transanally performed pull through, a preliminary biopsy should be performed to determine the pathological transition zone. It can be done laparoscopically.
After a surgical pull-through, many patients will continue to experience issues like enterocolitis, incontinence, and obstructive symptoms. It is crucial to diagnose and treat these issues in a systematic manner.