Jiang S, Song CY, Feng MX, Lu YQ. Adult patients with allied disorders of Hirschsprung’s disease in emergency department: An 11-year retrospective study. World J Gastrointest Surg 2022; 14(7): 656-669 [PMID: 36158276 DOI: 10.4240/wjgs.v14.i7.656]
Corresponding Author of This Article
Yuan-Qiang Lu, MD, PhD, Professor, Department of Emergency Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. luyuanqiang@zju.edu.cn
Research Domain of This Article
Emergency Medicine
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jul 27, 2022; 14(7): 656-669 Published online Jul 27, 2022. doi: 10.4240/wjgs.v14.i7.656
Adult patients with allied disorders of Hirschsprung’s disease in emergency department: An 11-year retrospective study
Shuai Jiang, Cong-Ying Song, Meng-Xiao Feng, Yuan-Qiang Lu
Shuai Jiang, Cong-Ying Song, Meng-Xiao Feng, Yuan-Qiang Lu, Department of Emergency Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Shuai Jiang, Cong-Ying Song, Meng-Xiao Feng, Yuan-Qiang Lu, Key Laboratory for Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases of Zhejiang Province, Hangzhou 310003, Zhejiang Province, China
Author contributions: Jiang S and Lu YQ conceived and designed the study; Jiang S and Feng MX collected the clinical data; Jiang S and Song CY provided statistical advice on study design and analyzed the data; Jiang S drafted the manuscript; and all authors contributed substantially to manuscript revision; Lu YQ takes responsibility for the paper as a whole.
Supported bythe Foundation of Key Discipline Construction of Zhejiang Province for Traditional Chinese Medicine, No. 2017-XK-A36.
Institutional review board statement: This study was approved by the Ethics Committee of the First Affiliated Hospital, Zhejiang University School of Medicine (No. 2021271).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuan-Qiang Lu, MD, PhD, Professor, Department of Emergency Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. luyuanqiang@zju.edu.cn
Received: August 17, 2021 Peer-review started: August 17, 2021 First decision: September 12, 2021 Revised: September 21, 2021 Accepted: June 24, 2022 Article in press: June 24, 2022 Published online: July 27, 2022 Processing time: 344 Days and 5 Hours
ARTICLE HIGHLIGHTS
Research background
In the past years, only a few studies with a limited number of adult patients analyzed the clinical features of allied disorders of Hirschsprung’s disease (ADHD).
Research motivation
Although many studies have reported patients presenting to the emergency department (ED) with recurrent abdominal symptoms for a number of disorders, there are few data involving ADHD. It is hard for most ED doctors to associate common abdominal symptoms with ADHD specifically.
Research objectives
To assist ED clinicians in having a more comprehensive understanding of this disease and making an early suspected diagnosis of ADHD more effectively.
Research methods
We enrolled 53 patients who visited the ED and were eventually diagnosed with ADHD over the past 11 years in our hospital. Their basic information, clinical manifestations, and imaging findings were analyzed. Blood indices were compared between the ADHD and irritable bowel syndrome (IBS) groups.
Research results
About 77.4% of adult patients with ADHD had been treated before admission. The transverse colon was the most common dilated part (73.6%), and constipation (67.9%) was the most common symptom. ADHD patients can present with uncommon symptoms and false-negative imaging findings. Logistic regression analysis indicated that body mass index (BMI), cholinesterase, and blood chlorine were determined to be independent related factors between ADHD and IBS.
Research conclusions
Emergency physicians should be vigilant regarding patients with chronic constipation, abdominal pain, or abdominal distension, and consider the possibility of ADHD despite its rarity. Abdominal computed tomography examination is recommended as a useful tool in the suspected diagnosis of ADHD. BMI, cholinesterase, and blood chlorine have good discriminative abilities between ADHD and IBS. The nutritional status of adult patients with ADHD is worthy of further attention. Surgical treatment for adult patients with ADHD is important and inevitable.
Research perspectives
Large samples will be used to verify our results and discover more powerful models for ADHD. In addition, we will follow up with the patients for a longer period, including postoperative quality of life, and comparison of nutritional status before and after surgery. Future work requires more in-depth research on the molecular mechanisms, signal pathways, and biomarkers of ADHD.
