Clinical manifestations of Hirschsprung’s disease in children aged 1 to 3 years

Clinical manifestations of Hirschsprung's disease (HD) in children aged 1 to 3 years depend on many factors, namely the extent of colonic aganglionosis (CA), the age of patients, the presence of associated congenital malformations and severe complications. Purpose - to study the features of the clinical manifestations of HD in children aged 1 to 3 years for the early detection and verification of this pathology. Materials and methods. We conducted a retrospective analysis of the clinical manifestations of HD in 268 children aged 1 to 3 years: 74 (27.62%) children with the rectal form of HD, 187 (69.77%) with rectosigmoid form and 7 (2.61%) with subtotal form. Associated malformations were found in 50 (18.66%). To study the clinical course, we considered the anamnesis, physical examination, data of general clinical laboratory indicators of blood, urine and feces, electrocardiography, neurosonography, echocardiography, ultrasound and X-ray dianostics. Results. Hypotrophy was found in 54 (20.15%) children: the first degree in 9 (3.36%) children, the second degree in 34 (12.69%) and the third degree in 11 (4.1%) patients. Laboratory tests revealed mild anemia in 4 (1.49%), moderate anemia in 11 (4.1%), and severe anemia in 31 (11.57%) children. The HD course was complicated by enterocolitis in 25 (33.78%) of 74 patients with rectal, in 86 (46.52%) of 187 children with rectosigmoidal and in 7 (100%) of 7 children with subtotal CA. Toxic megacolon was diagnosed in 6 (3.21%) patients. Conclusions. Associated malformations and late diagnosis are the main causes of severe complications of HD in children aged 1 to 3 years: enterocolitis (44.03%), toxic megacolon (4.85%), hypotrophy (20.15%) and anemia (17.16%). The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of all institutions mentioned in the work. Informed consent of the children’s parents was obtained for the research. No conflict of interests was declared by the authors.