The Effect of the Ganglionic Segment Inflammatory Response to Postoperative Enterocolitis in Hirschsprung Disease

Introduction: We examined the relationship between proinflammatory cytokines that occur in the inflammatory reaction in the intestine in Hirschsprung disease (HD) and Hirschsprung-associated enterocolitis (HAEC). Methods: Thirty cases (M:27, F:3) operated on due to HD. The cases were divided into three groups: group 1 with pre and post operative EC, group 2 with post-operative, and group 3 with pre-operative EC. The intestinal segments were evaluated by immunohistochemistry for interleukin 1 beta (IL-1ss), tumor necrosis factor-alpha (TNF-alpha), and interleukin 6 (IL-6). Results: IL-1 beta staining was significantly higher in the ganglionic zone of groups with enterocolitis compared to the control group (p = 0.012). TNF-alpha staining in the transitional zone of Group 3 and IL-1 beta staining in the ganglionic zone of Group 1 was significantly higher than the control group (p = 0.030, p = 0.020). Conclusion: In our study, older age at diagnosis and more than 20% IL-1ss staining in the ganglionic segment were found to be risk factors for HAEC. It is noteworthy that the increase in IL-1ss can be associated with HAEC.