The utilization of botulinum toxin for Hirschsprung disease.
Document Type
Article
Publication Date
4-2022
Identifier
DOI: 10.1016/j.sempedsurg.2022.151161
Abstract
Patients with Hirschsprung disease (HD) can struggle with persistent obstructive symptoms even after a successful pull-through. These symptoms lead to stasis of stool and can result in Hirschsprung associated enterocolitis (HAEC). Recurrent episodes of HAEC warrant further workup; if there are no signs of mechanical obstruction or an aganglionic pull-through, the use of botulinum toxin injections to the internal anal sphincter has been utilized to relieve these symptoms. In this review, we describe the variations in botulinum toxin injection use and describe ongoing studies to prevent obstructive symptoms and Hirschsprung-associated enterocolitis (HAEC). Botulinum toxin injection utilization has been described for obstructive symptoms after HD pull-through, in the setting of active HAEC, and has been proposed to be part of the treatment algorithm for prevention of HAEC after pull-through. Dosing utilized for the injections, along with the complications, are also described. Prospective, multi-institutional trials are needed to identify the effectiveness of botulinum toxin injections in the outpatient/prophylactic setting as current data suggest some benefits in preventing future obstructive symptoms; however, other studies have conflicting results.
Journal Title
Seminars in pediatric surgery
Volume
31
Issue
2
First Page
151161
Last Page
151161
Keywords
Botox; Botulinum toxin; Enterocolitis; Hirschsprung associated enterocolitis; Hirschsprung disease; Pullthrough
Recommended Citation
Svetanoff WJ, Lim-Beutal IIP, Wood RJ, Levitt MA, Rentea RM. The utilization of botulinum toxin for Hirschsprung disease. Semin Pediatr Surg. 2022;31(2):151161. doi:10.1016/j.sempedsurg.2022.151161
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