In some presentations of Hirschsprung's disease, rectal irrigations are insufficient to adequately decompress the bowel, or the patient develops complications — including enterocolitis unresponsive to non-operative treatment, or bowel perforation. In these situations, surgical intervention is indicated.
Management in this setting centres on a surgical diversion procedure to relieve obstruction and address the complication. The specific approach — and the recommended level of intervention — depends on the clinical picture.
Full regimen details, surgical considerations, and decision criteria available in the complete protocol →A stoma is indicated if rectal irrigations do not sufficiently decompress the bowel, or there are complications such as enterocolitis unresponsive to non-operative treatment, or bowel perforation.
The safest empiric level is an ileostomy.