Enterocolitis Is a Risk Factor for Bowel Perforation in Neonates With Hirschsprung's Disease: A Retrospective Multicenter Study

Frontiers in Pediatrics

article

Tianqi Zhu¹  Guofeng Zhang³  Xinyao Meng¹  Jixin Yang¹  Yonghua Niu¹  Ying He¹  Heying Yang³  Xiaofeng Xiong⁴  Jiexiong Feng¹ 

[1] Department of Pediatric Surgery, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology;Hubei Clinical Center of Hirschsprung Disease and Allied Disorders;Department of Pediatric Surgery, The First Affiliated Hospital of Zhengzhou University;Department of Neonatal Surgery, Wuhan Children's Hospital

关键词: Hirschsprung disease;    bowel perforation;    enterocolitis;    risk factor;    neonates;   

DOI  :  10.3389/fped.2022.807607

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background and Aim We evaluated the clinical features of neonatal Hirschsprung's disease (HD)-associated bowel perforation (perforated HD) and investigated risk factors related to it. Methods We retrospectively collected clinical data of neonates (<1 month of age) with perforated HD from multicenters in China from January 2006 to December 2019. A total of 142 patients (6.7%) with perforated HD were enrolled in the study. A 1:2 matching method was used to compare the clinical information of HD patients with and without bowel perforation during the neonatal period. The risk factors for bowel perforation were identified using univariate and multivariate logistic risk regression analyses. Results Perforation site was present in the proximal ganglionic bowel in 101 (71.1%) cases and the distal aganglionosis segment in 41 (28.9%) cases. Adjacent marginal tissue from the perforated intestine revealed varying degrees of inflammatory cell infiltration, and the severity of enterocolitis was higher in the proximal ganglionic bowel than in the distal aganglionosis segment ( p < 0.05). In the univariable and multivariable logistic analyses, clinical symptoms, such as vomiting (adjusted OR = 2.06, 95% CI: 2.01–2.88, p < 0.05), and inflammation index in hematologic tests, such as neutrophil proportion (adjusted OR = 1.09, 95% CI: 1.05–1.33, p < 0.05) and CRP (adjusted OR = 2.13, 95% CI: 1.01–3.27, p < 0.05) were associated with increased risk for perforated HD. Conclusion Clinical Hirschsprung disease-associated enterocolitis (HAEC) highly correlated with perforated HD. Timely treatment of HAEC should be appropriate therapeutic approaches to prevent perforated HD.

【 授权许可】

CC BY