An Updated “Historical” Algorithm for Hirschsprung Pa-tients Who Present Late or Severely Ill

Some children with previously undiagnosed Hirschprung’s disease present severely ill at an advanced age with markedly dilated bowel and enterocolitis. In this manuscript, the authors propose the following treatment algorithm: 1) a diverting transverse loop colostomy, 2) a transanal Soave endorectal pull-through, and 3) colostomy closure. The authors report their experience with five patients.