PEDIATRICS Vol. 96 No. 1 July 1995, pp. 118-121
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Unexpected Death From Enterocolitis After Surgery for Hirschsprung's Disease

Terri L. Marty MD1, Michael E. Matlak MD2, Margo Hendrickson MD3, Richard E. Black MD2, and Dale G. Johnson MD2

1 Department of Surgery, University of Utah and Primary Children's Medical Center, Salt Lake City
2 Departments of Surgery and Pediatrics, University of Utah and Primary Children's Medical Center, Salt Lake City
3 Department of Pediatric Surgery, Sunrise Hospital, Las Vegas, NV

Unanticipated death from enterocolitis occurred in five children 3 weeks to 20 months after uncomplicated reconstruction for Hirschsprung's disease. In each case the presenting symptoms of enterocolitis were mild and were misinterpreted by examining physicians. Within 2 to 12 days of onset of symptoms, unexpected death occurred. Although fatal enterocolitis is a well-known complication of Hirschsprung's disease, emphasis is usually placed on preoperative enterocolitis. Fatal postoperative enterocolitis is not a new entity associated with Hirschsprung's disease, but physician awareness of this possibility is obviously deficient. We strongly recommend extensive parent education and better postoperative communication between the surgeon and the referring physician.

Submitted on June 27, 1994
Accepted on September 19, 1994