Correspondence to Author: Christopher C. Amah, Ijeoma C. Obianyo, Linda O. Okoh, Nene E, Agugua-Obianyo. 

Department of Paediatric Surgery, University of Nigeria Teaching Hospital, Enugu

DOI: 10.52338/wjsurgy.2025.4475

Abstract:

Background: Hirschsprung’s Disease (HD) is a cause of intestinal obstruction in children. In recent times operative management has transited from multiple to single stage procedure in developed countries. However, in resource-poor settings of the developing countries, this transition is slow to occur, with most of the patients still requiring multi-stage operation due to late presentation.
Objective: We retrospectively reviewed all cases of HD managed over a period of 15 years at the University of Nigeria Teaching Hospital (UNTH) Enugu, Nigeria to determine the status of the transition from multiple to single stage operative management. Patients And Method: The clinical records of all children diagnosed and managed at UNTH between January 2008 and December 2022 (15 years) were reviewed. Demographic data collected included age at first presentation, key clinical features, type of HD, operative treatment (single or multi-stage), type of definitive operation, post-op complications, length of hospital stay, and outcome. Each patient’s data were collected on a proforma specifically designed for the study. The data were collated and analyzed by SPSS version 25.
Results: : The total number of cases analyzed was 44, comprising 35 males and 9 females with M/F ratio of 3.9:1. The age at first presentation ranged from 2 weeks to 10 years with a mean age of 3.8 years. The key symptoms were delayed passage of meconium (91%), chronic constipation (100%) and abdominal distension (80%). Of the 44 cases, 32 (72.7%) were of the short segment type, 7 (15.9%) ultra-short, and 5 (11.4%) long segments. Operative management of the patients was multi-staged with a preceding colostomy in 31 (70%). 13 (30%) patients who presented early without megacolon had the single=stage procedure done without a preceding colostomy. Majority of the patients, 38 (86.4%), had no post operative complications. The length of hospital stay varied from 8 to 35 days; mean of 18.4 days.
Conclusion: Because of late presentation of patients with HD in our sub-region , multi–staged operative treatment continues to dominate the practice. Targeted public awareness campaigns for early presentation of cases and improved access to paediatric surgical care, remain the cornerstone for achieving the desired transition.

Keywords:Hirschsprung’s disease, single vs multi–staged operation.

Citation:

Dr.Ijeoma C. Obianyo, Management Of Hirschsprung’s Disease Revisited: Single-Stage Versus Multi-Stage Operation: A 15 Year Retrospective Review Of Cases Seen At The University Of Nigeria Teaching Hospital Enugu, Nigeria. World Journal of Clinical Surgery 2025.