Management of uncommon complications of definitive operations of Hirschsprung's disease

Abstract

In Hacettepe University Children's Hospital, 229 Hirschsprung patients who had undergone definitive operations of Hirschsprung's disease (HD) between 1976-1993 were evaluated for the occurrence of uncommon complications. Two hundred and thirteen of these patients were operated on in our hospital and 16 of them referred to us after definitive operation. The most uncommon complication in the presented series was the fistula; namely rectourinary, rectovaginal, ileorectal and perianal. One patient acquired rectourethral fistula after Swenson operation. He had undergone redo Swenson operation after an unsuccessful attempt of fistula repair. In our series we detected two patients with ileorectal fistula one of them has also a perianal fistula. These two patients were presented with intractable enterocolitis that caused a delay in treatment. Both of them had undergone ileorectal fistula repair with success. We encountered two rectovaginal fistulae among patients who were referred to us after definitive operations. Both of them were managed with redo operation. One patient was referred to us after Swenson operation with perianal fistula and had undergone fistulotomy. The management of rectourinary and rectovaginal fistulae other than redo operation was proved to be unsuccessful.