Features of the clinic, diagnosis and tactics of surgical treatment of Hirshprung's disease in infants

The aim is to present optimal ways of early diagnosis and tactics Hirschsprung's disease (HD) surgical correction in newborns young children based on literature data our own experience. Materials methods. Clinical observations optimization the treatment HD 58 infants over past 9 years have been carried out. All patients underwent a complex general physical examinations, including collection anamnesis follow-up patients, clinical examination with rectal examination, laboratory, bacteriological, radiological (survey, polypositional irrigography) morphological (intraoperatively remote area colon agangliosis zone) studies. features course infants, choice method were analyzed, risk complications during operation was studied. divided into two groups. first group included 32 (55.2%) typical HD, radiographically confirmed rectosigmoid zone, chronic constipation. second 26 (44.8%) an atypical diarrheal syndrome against background dysbiosis, enterocolitis, among them there 2 symptoms Hirschsprung-associated enterocolitis. Research methods: General biochemical analysis blood urine. Scatological feces, sowing pathogenic flora feces EKG. Ultrasound abdominal cavity echocardiography. X-ray examination: overview roentgenogram thoracic vertically, irrigoraphy, excretory urography. Results conclusions. In sub- decompensated constipation absence effect conservative therapy, after established, radical or colostomy application above zone recommended. favorable left-sided form transanal endorectal reduction large intestine (TENTC) can be performed according indications, starting from one month age. this case, TENTK without colostomy. subtotal rectosigmoidal forms long aganglionic laparoscopic assistance recommended, which makes it possible release splenic flexure ligaments constrictions, take full-thickness biopsy transitional aganglionicosis, conduct express diagnostics, establish resection levels freely lower proximal TENTC. research out accordance principles Helsinki Declaration. study protocol approved by Local Ethics Committee all participating institution. informed consent patient obtained for conducting No conflict interest declared authors. Key words: Hirschsprung’s disease, clinic, trans anal reduction.