Hirschsprung associated enterocolitis (HAEC) is an infection or inflammation of the bowel that can occur in children both before and after their surgical procedure. There are several factors that cause HAEC, including:
- An intestinal blockage
- A bacterial or viral infection
- Other anatomical or underlying conditions caused by Hirschsprung disease
Symptoms of HAEC include:
- Severe diarrhea
- Poor feeding
- Rectal bleeding
Management and Treatment of HAEC
HAEC can range from moderate to severe, and in some cases, potentially be life- threatening. HAEC can come on suddenly and will require immediate treatment and care. Treatment for HAEC will depend on the grade (severity of the condition).
Grade I HAEC:
Treatment for Grade I HAEC can be done on an outpatient basis and may include:
- Hydration with Pedialyte or another electrolyte-rich solution
- Oral metronidazole (an antibiotic used to treat certain bacterial and parasitic infections)
- A regimen of saline enemas to wash the lining of the bowel to help eliminate liquid stool or gas
Grade II HAEC:
Treatment for Grade II HAEC entails treatment in the hospital with intravenous fluids. Nothing is given by mouth. When there is significant abdominal distention, nasogastric decompression (the insertion of a plastic tube through the nose, past the throat and down into the stomach) may be done to drain the contents of the stomach.
Other treatments include:
- Oral metronidazole
- Other broad-spectrum intravenous antibiotics
- Close monitoring of the child clinically and with the use of advanced imaging to watch for the development of pneumoperitoneum (abnormal air or gas in the abdominal cavity)
Grade III HAEC:
For more severe Grade III HAEC, all of the above treatments will be given and the child will likely be admitted to the intensive care unit for close observation. If pneumoperitoneum develops, immediate surgical intervention will be required.