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World J Gastrointest Surg. Aug 27, 2021; 13(8): 822-833
Published online Aug 27, 2021. doi: 10.4240/wjgs.v13.i8.822
Persistent bowel dysfunction after surgery for Hirschsprung’s disease: A neuropathological perspective
Sanne J Verkuijl, Florian Friedmacher, Patrick N Harter, Udo Rolle, Paul MA Broens
Sanne J Verkuijl, Florian Friedmacher, Udo Rolle, Department of Pediatric Surgery, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt 60590, Germany
Sanne J Verkuijl, Patrick N Harter, Neurological Institute (Edinger-Institute), University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt 60528, Germany
Sanne J Verkuijl, Paul MA Broens, Department of Surgery, Division of Pediatric Surgery, University of Groningen, University Medical Center Groningen, Groningen 9700 RB, Netherlands
Author contributions: Verkuijl SJ and Friedmacher F drafted the manuscript; Friedmacher F, Harter PN, Rolle U and Broens PMA critically read and revised the manuscript.
Conflict-of-interest statement: The authors declare no conflict of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sanne J Verkuijl, BSc, Research Fellow, Department of Pediatric Surgery, University Hospital Frankfurt, Goethe University Frankfurt, Theodor-Stern-Kai 7, Frankfurt 60590, Germany. s.j.verkuijl@umcg.nl
Received: February 12, 2021
Peer-review started: February 12, 2021
First decision: May 4, 2021
Revised: May 12, 2021
Accepted: July 5, 2021
Article in press: July 5, 2021
Published online: August 27, 2021
Core Tip

Core Tip: Hirschsprung’s disease (HD) is a congenital disorder, characterized by aganglionosis in the distal part of the gastrointestinal tract. Despite surgical resection of the aganglionic bowel segment, bowel dysfunction persists in a considerable number of patients with limited treatment options. There is growing evidence regarding structural abnormalities in the proximal, ganglionic colon of both humans and animals with HD, which may play a role in persistent bowel dysfunction. Hence, understanding these previously unrecognized neuropathological abnormalities in the proximal, ganglionic bowel of patients with HD may improve current follow-up and treatment of persistent postoperative bowel dysfunction in certain patients.