Published online Jul 27, 2022. doi: 10.4240/wjgs.v14.i7.656
Peer-review started: August 17, 2021
First decision: September 12, 2021
Revised: September 21, 2021
Accepted: June 24, 2022
Article in press: June 24, 2022
Published online: July 27, 2022
In the past years, only a few studies with a limited number of adult patients analyzed the clinical features of allied disorders of Hirschsprung’s disease (ADHD).
Although many studies have reported patients presenting to the emergency department (ED) with recurrent abdominal symptoms for a number of disorders, there are few data involving ADHD. It is hard for most ED doctors to associate common abdominal symptoms with ADHD specifically.
To assist ED clinicians in having a more comprehensive understanding of this disease and making an early suspected diagnosis of ADHD more effectively.
We enrolled 53 patients who visited the ED and were eventually diagnosed with ADHD over the past 11 years in our hospital. Their basic information, clinical manifestations, and imaging findings were analyzed. Blood indices were compared between the ADHD and irritable bowel syndrome (IBS) groups.
About 77.4% of adult patients with ADHD had been treated before admission. The transverse colon was the most common dilated part (73.6%), and constipation (67.9%) was the most common symptom. ADHD patients can present with uncommon symptoms and false-negative imaging findings. Logistic regression analysis indicated that body mass index (BMI), cholinesterase, and blood chlorine were determined to be independent related factors between ADHD and IBS.
Emergency physicians should be vigilant regarding patients with chronic constipation, abdominal pain, or abdominal distension, and consider the possibility of ADHD despite its rarity. Abdominal computed tomography examination is recommended as a useful tool in the suspected diagnosis of ADHD. BMI, cholinesterase, and blood chlorine have good discriminative abilities between ADHD and IBS. The nutritional status of adult patients with ADHD is worthy of further attention. Surgical treatment for adult patients with ADHD is important and inevitable.
Large samples will be used to verify our results and discover more powerful models for ADHD. In addition, we will follow up with the patients for a longer period, including postoperative quality of life, and comparison of nutritional status before and after surgery. Future work requires more in-depth research on the molecular mechanisms, signal pathways, and biomarkers of ADHD.