Update Course Rewind 2025: Hirschsprung’s Pull-Through: Why Family Training May Save Lives

In the literature, there is not really evidence of good timing to perform a pull-through procedure for Hirschsprung disease.

A 2021 PCPLC retrospective study compared outcomes of neonatal pull-through versus delayed primary pull-through for Hirschsprung disease.

One expert delays pull-through at least 1 month, sometimes 3 months, depending on when the family can return, because they want families to demonstrate they can do irrigations at home.

Family skill in performing irrigations is an important skill for Hirschsprung patients.

Families who are really good at irrigations will save a baby's life in Hirschsprung disease.

Children whose families cannot perform adequate washouts may not be able to go home and remain inadequately decompressed, leading to hospitalization with colitis or perforation.