Histopathological changes and Hirschsprung’s associated enterocolitis (HAEC) scores

https://doi.org/10.19106/JMedSci005203202004

Reinaldo Sunggiardi(1*), Nita Mariana(2), Farid Nurmantu(3), . Ahmadwirawan(4), Tommy R. Habar(5), . Sulmiati(6), Harsali F. Lampus(7), Andi Alfian Zainuddin(8), . Prihantono(9)

(1) Division of Pediatric Surgery, Departement of Surgery, Faculty of Medicine, Hasanuddin University, Makassar,
(2) Division of Pediatric Surgery, Departement of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
(3) Division of Pediatric Surgery, Departement of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
(4) Division of Pediatric Surgery, Departement of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
(5) Division of Pediatric Surgery, Departement of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
(6) Division of Pediatric Surgery, Departement of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
(7) Division of Pediatric Surgery, Departement of Surgery, Faculty of Medicine, Sam Ratulangi University, Manado, Indonesia
(8) Department of Public Health, Faculty of Medicine, Hasanuddin University, Makasar, Indonesia
(9) Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
(*) Corresponding Author

Abstract


Histopathological changes that are usually permanent in the bowel of Hirschsprung’s disease (HRSC) in children make susceptibility to the incidence of enterocolitis even after definitive therapy. The pathophysiology of HRSC is characterized by specific signs, and symptoms. Scoring system has been applied in diagnosis of Hirschsprung’s associated enterocolitis (HAEC) due to its simplest and easiest. However, after a decade it has been several evaluated to obtain optimal benefits in the clinical setting. The aim of this study was to investigate the relationship between histopathological grade of enterocolitis and HAEC scores. Children with HRSC who underwent leveling colostomy or pull-through were sampled from the ganglionic segment. Those with a histopathological description of HAEC were included in the study. HAEC scores were evaluated retrospectively through medical records and interviews. Data were analyzed using the Spearman’s Rank test. Twenty eight samples were involved in this study. The population was dominated by male (82.1%) and almost half the population (42.9%) were infants. The distribution of the histopathological grade was fairly even, except for grade V where it was only 7.2% of the total sample. Grade I & III samples were 21.4%, while grade II & IV were 25%, respectively. A significant relationship between histopathological grade and HAEC score was obtained (r = 0.927; p<0.0001). In conclusion, there is a relationship between the histopathological grade of enterocolitis and HAEC scores.


Keywords


Hirschsprung’s-associated enterocolitis (HAEC); Histopathology; HAEC Score;

Full Text:

PDF


References

  1. Sergi C. Hirschsprung’s disease: Historical notes and pathological diagnosis on the occasion of the 100th anniversary of Dr. Harald Hirschsprung’s death. World JClin Pediatr 2015; 4(4):120-5. https://doi.org/10.5409/wjcp.v4.i4.120
  2. Sellers M, Udaondo C, Moreno B, Alés GM, Díez J, Martínez L, et al. Hirschsprung-associated enterocolitis: Observational study in a paediatric emergency care unit. Anales de Pediatría (English Edition) 2018; 88(6):329-34. https://doi.org/10.1016/j.anpede.2017.07.006
  3. Nguyen LA, Righini-Grunder F, Piché N, Faure C, Aspirot A. Factors influencing the incidence of Hirschsprung associated enterocolitis (HAEC). J Pediatr Surg 2019; 54(5):959-63. https://doi.org/10.1016/j.jpedsurg.2019.01.026
  4. Austin KM. The pathogenesis of Hirschsprung’s disease-associated enterocolitis. Semin Pediatr Surg 2012; 21(4):319-27. https://doi.org/10.1053/j.sempedsurg.2012.07.006
  5. Demehri FR, Halaweish IF, Coran AG, Teitelbaum DH. Hirschsprung-associated enterocolitis: pathogenesis, treatment and prevention. Pediatr Surg Int 2013; 29(09):873–81. https://doi.org/10.1007/s00383-013-3353-1
  6. Dore M, Sanchez AV, Junco PT, Barrena S, De Ceano-Vivas M, Gomez JJ, Moreno AM, Santamaria ML, Martinez L. Reliability of the Hirschsprung-associated enterocolitis score in clinical practice. Eur JPediatr Surg 2019; 29(01):132-7. https://doi.org/10.1055/s-0038-1677046
  7. Tang W, Su Y, Yuan C, Zhang Y, Zhou L, Peng L, et al. Prospective study reveals a microbiome signature that predicts the occurrence of post-operative enterocolitis in Hirschsprung disease (HSCR) patients. Gut Microbes 2020; 1-13. https://doi.org/10.1080/19490976.2020.1711685
  8. Demehri FR, Frykman PK, Cheng Z, Ruan C, Wester T, Nordenskjöld A, et al. Altered fecal short chain fatty acid composition in children with a history of Hirschsprung-associated enterocolitis. J Pediatr Surg 2016; 51(1):81-6. http://doi.org/10.1016/j.jpedsurg.2015.10.012
  9. Mariana N, Islam AA, Massi MN, Hatta M, Patellongi I. ITGB2 (CD18) mRNA Expression in Hirschsprung-Associated Enterocolitis (HAEC). Indian J Public Health Res Develop 2019; 10(8):1015-20.
  10. Frykman PK, Patel DC, Kim S, Cheng Z, Wester T, Nordenskjöld A, et al. Inflammatory bowel disease serological immune markers anti-saccharomyces cerevisiae mannan antibodies and outer membrane porin C are potential biomarkers for Hirschsprung-associated enterocolitis. J Pediatr Gastroenterol Nutr 2019; 69(2):176-81. http://doi.org/10.1097/MPG.0000000000002358
  11. Soh HJ, Nataraja RM, Pacilli M. Prevention and management of recurrentpostoperative Hirschsprung’s disease obstructive symptoms and enterocolitis: Systematic review and meta-analysis. J PediatrSurg 2018; 53(12):2423-9. https://doi.org/10.1016/j.jpedsurg.2018.08.024
  12. Jiao CL, Chen XY, Feng JX. Novel insights into the pathogenesis of Hirschsprung’s-associated enterocolitis. Chinese Med J 2016; 129(12):1491-7. http://doi.org/10.4103/0366-6999.183433
  13. Elhalaby EA, Teitelbaum DH, Coran AG, Heidelberger KP. Enterocolitis associated with Hirschsprung’s disease: a clinical histopathological correlative study. J Pediatr Surg 1995; 30(7):1023-7. https://doi.org/10.1016/0022-3468(95)90334-8
  14. Pastor AC, Osman F, Teitelbaum DH, Caty MG, Langer JC. Development of a standardized definition for Hirschsprung’s-associated enterocolitis: a Delphi analysis. J Pediatr Surg 2009; 44(1):251-6. http://doi.org/10.1016/j.jpedsurg.2008.10.052
  15. Frykman PK, Kim S, Wester T, Nordenskjöld A, Kawaguchi A, Hui TT, et al. HAEC Collaborative Research Group. Critical evaluation of the Hirschsprung-associated enterocolitis (HAEC) score: a multicenter study of 116 children with Hirschsprung disease. J Pediatr Surg 2018; 53(4):708-17. https://doi.org/10.1016/j.jpedsurg.2017.07.009
  16. Yulianda D, Sati AI, Makhmudi A, Gunadi. Risk factors of preoperative Hirschsprung - enterocolitis. BMC Proc 2019; 13(Suppl 11):18. https://doi.org/10.1186/s12919-019-0172-y
  17. Cheng S, Wang J, Pan W, Yan W, Shi J, Guan W, Wang Y, et al. Pathologically assessed grade of Hirschsprung-associated enterocolitis in resected colon in children with Hirschsprung’s disease predicts postoperative bowel function. J Pediatr Surg 2017; 52(11):1776-81. http://doi.org/10.1016/j.jpedsurg.2017.03.056
  18. Sosnowska P, Blaszczynski M, Morycinski S, Mankowski P. Definitive surgery for Hirschsprung’s disease under 4 months of age is associated with long-term complications: A cohort study. Pediatria Polska 2017; 92(5):548-52.
  19. Gosain A, Frykman PK, Cowles RA, Horton J, Levitt M, Rothstein DH, et al. Guidelines for the diagnosis and management of Hirschsprung-associated enterocolitis. Pediatr Surg Int 2017; 33(5):517-21. http://doi.org/10.1007/s00383-017-4065-8
  20. Haricharan RN, Seo JM, Kelly DR, Mroczek-Musulman EC, Aprahamian CJ, Morgan TL, et al. Older age at diagnosis of Hirschsprung disease decreases risk of postoperative enterocolitis, but resection of additional ganglionated bowel does not. J Pediatr Surg 2008; 43(6):1115-23. http://doi.org/10.1016/j.jpedsurg.2008.02.039



DOI: https://doi.org/10.19106/JMedSci005203202004

Article Metrics

Abstract views : 2444 | views : 4315


Bookmark and Share


Copyright (c) 2020 Reinaldo Sunggiardi, Nita Mariana, Farid Nurmantu, . Ahmadwirawan, Tommy R. Habar, . Sulmiati, Harsali F. Lampus, Andi Alfian Zainuddin, . Prihantono

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.