MINI REVIEW article
Front. Surg.
Sec. Pediatric Surgery
Surgical decision making in late-presenting Hirshsprung's disease: direct pull though or stoma first
Provisionally accepted
Ahmed Arafa1*
Ahmed S. Ragab2Abdelhalem Showkat Mohamed3Mahmoud Tarek Mohamed1ahmed E. Arafat1
Abdelhafeez Mohamed Abdelhafeez4- 1Cairo University, Giza, Egypt
- 2Port Said University, Port Said, Egypt
- 3Minia University, Minya, Egypt
- 4Beni-Suef University, Beni Suef, Egypt
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ABSTRACT Aim of the study: To describe staging or not in cases of Hirschsprung's disease in older children Methods: 30 patients were diagnosed as HSD, all cases were proved by rectal biopsy, rectal irrigation for 2 months was done, for colonic decompression, failure of conservative management was occurred to decompress colon in 15 cases, so colostomy or ileostomy was done according to site of transitional zone distal or proximal to transverse colon respectively, before definitive procedure which postponed after 2 months. 8 cases Laparoscopic Duhamel,7 cases laparoscopic aided Swenson were done in one stage. Results: Anal dilation program was done 3 weeks after pull through, we had in Swenson cases stenosis in 3 cases; enterocolitis in 2 cases, postoperatively that responded to conservative treatment and one case of fecal incontinence. In Duhamel cases, we had 3 cases of constipation and three cases of enterocolitis, there was no anastomotic leak. 4 cases of stomal prolapse, skin excoriation was occurred in all staged operation Conclusion: Safety of either procedure in cases of HSD in older children either staging or not Keywords: Staging, Duhamel, Swensons. Hirshsprung's disease-stoma .
Keywords: Duhamel, Hirshsprung's disease, staging, stoma, Swensons
Received: 23 Dec 2025; Accepted: 12 Jan 2026.
Copyright: © 2026 Arafa, Ragab, Mohamed, Mohamed, Arafat and Abdelhafeez. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ahmed Arafa
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