Hirschsprung's-Associated Enterocolitis (HAEC) Alert for clinicians

Information alert box Hirschsprung's-Associated Enterocolitis (HAEC) Alert

It can be difficult to tell whether a child with Hirschsprung's has a tummy bug or enterocolitis.When in doubt, it is best to assume enterocolitis and seek treatment.

Advice for parents / carers | Bowel washout

Consider Hirschsprung's-Associated Enterocolitis (HAEC)

• This child has Hirschsprung's disease
• This child is known to the Oxford Children's Hospital Paediatric Colorectal Team
• HAEC can lead to sepsis, morbidity and mortality

Signs of Hirschsprung's-Associated Enterocolitis

• Reduced feeding and lethargy
• Distended abdomen
• Vomiting
• Diarrhoea (signs of gastroenteritis)
• Bloody or mucous-filled stools
• Pyrexia

Immediate care

• Stop oral feeding
• Continue dioralyte / water if tolerated

Investigations

• Blood tests (FBC, electrolytes, CRP, glucose, blood culture)
• Abdominal X-ray
• Urine and stool culture

Management

• Cannulate and start IV fluids (maintenance +/- bolus)
• Start IV ceftriaxone and metronidazole
• Pass an NG tube, leave on free drainage
• Rectal washout: most parents will be trained to do this, please support them with space and equipment

Contact Paediatric Surgical Team (via Switchboard 0300 304 7777 Bleep 1820)