Volume 30, Issue 175, September 2026

Development of postoperative obstructive symptoms in patients with Hirschsprung disease

Paula Szymańska^1♦, Ewelina Knapczyk¹, Maria Smółka¹, Patryk Omylak¹, Aleksandra Podraszka¹, Przemysław Prokop², Zuzanna Wróbel³

¹Medical University of Silesia, Katowice, Poland
²MedTech Association of Medical University of Silesia. Katowice, Poland
³Department of Neurology, Faculty of the Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland

^♦Corresponding author
Paula Szymańska, Medical University of Silesia, Katowice, Poland

ABSTRACT

Hirschsprung disease (HSCR) is a rare congenital disorder of the intestine, typically diagnosed in neonates presenting with delayed passage of meconium and signs of bowel obstruction. The gold-standard and life-saving procedure is the surgical resection of the segment of the colon lacking ganglion cells. A notable number of patients, nevertheless, experience long-term postoperative complications that significantly affect quality of life. This review analyzes 315 studies published between 2013 and 2025, focusing on complications after surgical treatment for HSCR, especially fecal incontinence (reported in up to 83.3% of cases), constipation (up to 66.7%), and Hirschsprung-associated enterocolitis (HAEC) (up to 48.5%). Several factors influence treatment outcomes, including age at operation, type of surgical procedure, length of aganglionosis, one-stage or multi-stage surgery, and the presence of HAEC before the operation. Patients with associated syndromes, e.g., Down syndrome, manifest a higher risk of bowel dysfunction. Children with HSCR frequently experience a lower quality of life than their peers, specifically in continence and psychosocial well-being. In contrast, adults report slightly more favorable long-term quality of life, especially in psychological and social domains. Differences in research plans, participant numbers, diagnostic criteria, and followup methods contribute to discrepancies in complication rates. In conclusion, although surgical intervention is essential, long-term multidisciplinary care and standardized follow-up are key for optimizing patient outcomes and quality of life.

Keywords: Hirschsprung disease, fecal incontinence, constipation, postoperative outcomes, HAEC

Medical Science, 2026, 30, e183ms3918

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DOI: https://doi.org/10.54905/disssi.v30i175.e183ms3918

Published: 05 September 2026