MODERN ADAPTATION OF DIAGNOSTIC AND THERAPEUTIC TACTICS IN CHILDREN WITH HIRSCHSPRUNG’S DISEASE.
Main Article Content
Abstract
Hirschsprung’s disease (HD) is a congenital disorder of the gastrointestinal tract caused by the absence of ganglion cells in the distal colon, resulting in functional obstruction and chronic constipation in children. Although considerable progress has been made in pediatric diagnostics and surgery, the short and ultra-short forms of HD remain poorly studied and diagnostically complex. This article reviews modern diagnostic methods including irrigoscopy, anorectal manometry, rectal biopsy, histochemical and immunohistochemical studies (acetylcholinesterase, calretinin), and highlights their significance in clinical practice. Therapeutic approaches, primarily surgical, are analyzed with a focus on one-stage transanal pull-through procedures and laparoscopic-assisted resections. Complications and long-term outcomes are also addressed. The findings suggest that multimodal diagnostics combined with individualized surgical tactics significantly improve treatment results and reduce postoperative complications.
Article Details
References
1. Абайханов Р.И. Дифференциальная диагностика короткосегментарной формы болезни Гиршпрунга у детей // Детская хирургия. – 2019. – №6. – С. 25–29.
2. Говорухина О.А. Осложнённые формы болезни Гиршпрунга: тактика диагностики и лечения // Хирургия. Журнал им. Н.И. Пирогова. – 2020. – №3. – С. 45–50.
3. Давлятов Р.М. Послеоперационные осложнения у детей с болезнью Гиршпрунга // Вестник педиатрии и детской хирургии. – 2018. – Т. 17, №4. – С. 63–68.
4. Сварич В.Г. Ультракороткие формы болезни Гиршпрунга: особенности диагностики // Детская колопроктология. – 2021. – №2. – С. 12–18.
5. Фёдоров А.К. Диагностические ошибки при болезни Гиршпрунга у детей // Российский журнал детской хирургии, анестезиологии и реаниматологии. – 2020. – Т. 10, №5. – С. 77–83.
6. Cobellis G., Mastroianni L., Cruccetti A. Histopathological features in Hirschsprung’s disease // Pediatr Surg Int. – 2004. – Vol. 20, No. 7. – P. 544–547.
7. Holschneider A.M., Puri P. Hirschsprung’s Disease and Allied Disorders. – 3rd ed. – Springer, 2008. – 500 p.
8. Temple S.J., Kapur R.P. Rectal suction biopsy in the diagnosis of Hirschsprung’s disease: effectiveness and limitations // J Pediatr Surg. – 2017. – Vol. 52, No. 8. – P. 1261–1266.
9. Ronzrokh M., Yousefi J. Diagnostic role of rectoanal inhibitory reflex in pediatric Hirschsprung’s disease // Iran J Pediatr. – 2019. – Vol. 29, No. 4. – P. 342–348.
10. Calretinin as an immunohistochemical marker in Hirschsprung’s disease: review and meta-analysis // Pediatr Dev Pathol. – 2015. – Vol. 18, No. 3. – P. 214–222.