Enterocolitis in a Child With Hirschsprung Disease

• Published in: Pediatric emergency care Vol. 35; no. 7; p. e131
• Main Authors: Guillaume, Alexander W D, Miller, Andrew C, Nguyen, Michael C
• Format: Journal Article
• Language: English
• Published: United States 01.07.2019
• Subjects: Enterocolitis - etiology; Enterocolitis - therapy; Hirschsprung Disease - complications; Hirschsprung Disease - surgery; Humans; Infant; Male; Shock - etiology
• ISSN: 1535-1815
• DOI: 10.1097/PEC.0000000000001108

Hirschsprung disease is a congenital abnormality that can be surgically corrected. However, Hirschsprung-associated enterocolitis can be a life-threatening sequela. Very little has been published in the emergency medicine literature about the risk of enterocolitis and shock in patients with a history of Hirschsprung disease. We describe the case of a 6-month-old male infant with a history of multiple surgeries for Hirschsprung disease who presented to the emergency department with a seemingly benign viral gastrointestinal illness. His stable condition led him to be discharged. However, 4 days later, he returned to the emergency department with severe diarrhea and was subsequently admitted to the pediatric intensive care unit for the management of enterocolitis and shock. With this case report, we aim to raise emergency physicians' awareness of the serious and possibly fatal complications of Hirschsprung disease. We argue that this single element of a patient's medical history can alter the management of seemingly simple viral gastrointestinal illnesses; rather than be discharged, such a patient requires surgical consultation and possibly admission for close monitoring and treatment.