Abstract
In modern literature, there are only isolated cases of diagnosis and treatment of Hirschsprung disease (HD) in school-aged children, and these cases are from pediatric surgical clinics in developing countries. Aim - to investigate the clinical and pathological symptoms of HD in school-aged children for early detection of this pathology. Materials and methods. We conducted a retrospective analysis of the clinical symptoms of HD in 196 school-aged children for the period from 1980 to 2021. There were 117 (59.69%) patients with the rectal form of HD, 76 (38.78%) with the rectosigmoid form, 3 (1.53%) with the subtotal form. To study the clinical course, we considered the data from the anamnesis, physical examination, general clinical laboratory parameters (blood, urine and feces), electrocardiography, echocardiography, ultrasonography, irrigography, manometry and rectal biopsy. Results. Among 196 school-aged patients with HD, we found enterocolitis in 86 (43.88%) patients: the 1st degree - in 16 (8.16%), the 2nd degree - in 29 (14.79%), and the 3rd degree - in 41 (20.92%) patients. Toxic megacolon was present in 9 (5.83%) patients. Anemia of various degrees was established in 24 (12.24%) patients. Associated malformations were found in 61 (31.12%) children, of which 18 (9.18%) patients had associated malformations of the intestine. The acute form of HD was established in 70 (35.71%) patients, subacute - in 64 (32.65%) children and chronic - in 62 (31.64%) patients. Conclusions. Clinical signs of HD in school-aged children are typical, which can be obtained by careful collection of anamnesis and evaluation of the patient’s objective examination. Irigography, manometry, and rectal biopsy are required to confirm the diagnosis of HD in school-aged children. 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.
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