These include stenosis or leakage from the anastomosis, intestinal obstructions, pelvic abscesses or lesions, incontinence, and enterocolitis. It is a grave mistake not to diagnose the disease, but the picture is not better when a false diagnosis of HD is made since the patient will not only be subject to the risk of surgery, but his or her real condition will not be treated while there may be a number of complications from the intervention that could even cause death. 2. Khan AR, Vujanic GM, Huddart S. The constipated child: how likely is Hirschsprungs disease? Pediatr Surg Int 2003; 19: 439-442. 4. López T. JC, Jaramillo B, LE. Papel o utilidad de la biopsia rectal en el estudio del paciente pediátrico con estreñimiento. Experiencia de cinco años en un centro de referencia colombiano 2011. Pendiente publicación. 5. De Lorijn F, Reitsma JB, Voskuijl WP, Aronson DC, Ten FJ Kate, Smets AM, Taminiau JA, Benninga M. Diagnosis of Hirschsprungs Disease: A Prospective, Comparative Accuracy Study of Common Tests. J Pediatr 2005; 146: 787-92. 6. Meier-Ruge W. Bruder E, Kapur RP. Intestinal Neuronal Dysplasia Type B: One Giant Ganglion is Not Good Enough. Pediatric and Developmental Pathology 2006; 9: 444-452. 7. Feichter S., Meier-Ruge WA, Bruderb E. The histopathology of gastrointestinal motility disorders in children. Seminars in Pediatric Surgery 2009; 18: 206-211. 8. Wakely PE Jr, McAdams AJ. Acetylcholinesterase histochemistry and the diagnosis of Hirschsprungs disease: a 3 1/2-year experience. Pediatr Pathol 1984; 21: 35-46. 10. Qualman SJ, Jaffe R, Bove KE. Monforte-Muñoz H. Diagnosis of Hirschsprung Disease Using the Rectal Biopsy: Multi-institutional Survey. Pediatric and Developmental Pathology, 1999; 2: 588-596. 11. Ariel I, Vinograd I, Lernau OZ et al. Rectal mucosal biopsy in Aganglionosis and allied conditions. Hum Pathol 1983; 14: 991-995. 12. Venugopal S, Mancer K, Shandling B. The validity of rectal biopsy in relation to morphology and distribution of ganglion cells. J Pediatric Surg 1981; 16: 433-437. 13. Guinard-Samuel V, Bonnard A, De Lagausie P, et al. Calretinin immunohistochemistry: a simple and efficient tool to diagnose Hirschsprung disease. Modern Pathology 2009; 22: 1379-1384.
La mortalidad en los casos tratados con cirugía es en general baja pero las complicaciones son muchas: estenosis o escurrimiento de la anastomosis, obstrucción intestinal, abscesos pélvicos o de la herida, incontinencia, enterocolitis, etc. Esto pone de manifiesto que es un error grave no diagnosticar la enfermedad pero que el panorama no es mejor cuando se establece una falso diagnóstico de EH ya que el paciente no solo va a ser sometido al riesgo de una cirugía que no le va a servir para su enfermedad sino que puede tener una serie de complicaciones por la intervención que le causa incluso la muerte.