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

Abstract

Abstract Purpose: We examined the relationship between inflammatory reactions in the intestine in Hirschsprung's disease (HD) and Hirschsprung-associated enterocolitis (HAEC). Methods: There were 30 cases (M:27, F:3) who were operated with the transanal endorectal pull-through (TERP) method for HD between 2012 and 2022. The cases were divided into three groups. Group 1: Cases with preoperative and postoperative enterocolitis, Group 2: Cases with postoperative enterocolitis, Group 3: Cases with preoperative enterocolitis. The intestinal segments removed during the surgery were evaluated for interleukin 1 beta (IL-1ß), tumour necrosis factor alpha (TNF-α), and interleukin 6 (IL-6). Results: In the compression of enterocolitis groups and control group, the average intensity of IL-ß staining percentages in lamina propria(LP) were 52,2±23,8% to 17,8±25,4% and in epithelium 50±23,6% to 22,1±24,6%. Those for TNF-α score of LP staining were 65,4±24% to 47,1±24,2%. It has been found that an increase of IL-1ß intensity in LP(p:0.002) and epithelium(p:0.014) of the positive ganglion side is related to enterocolitis. However, a similar relationship for TNF-α was found in only transitional zone LP(p:0.01). Conclusion: It has been shown that endogenous TNF-α secretion and IL-1β-related inflammation play a role in the etiology of HAEC. It has been thought that HAEC is not just an infective disease but an autoinflammatory process.