Comparison of vancomycin enema vs normal saline enema in patients with Hirschsprung-associated enterocolitis
Keywords:
Enterocolitis, Hirschsprung’s disease, HAEC, Vancomycin enema, Normal saline enemaAbstract
Background: Hirschsprung-associated enterocolitis (HAEC) is a serious complication of Hirschsprung’s disease, often leading to significant morbidity and prolonged hospitalization. While vancomycin enemas are commonly used, evidence comparing them with normal saline enemas remains limited, making it important to determine whether antibiotic enemas offer added benefit.
Methods: This study was conducted in the Department of Pediatric Surgery at the University of Child Health Sciences, Lahore, over 9 months following ethical approval. Sixty patients diagnosed with HAEC were randomly assigned to Group A (vancomycin enema) or Group B (normal saline enema), with 30 patients in each group. Data were analyzed using SPSS version 24.
Results: Of the 60 patients, 80% were male and 20% were female, with no significant age difference between groups (p = 0.144). Both groups demonstrated significant reductions in HAEC scores after treatment (8.37 and 8.16, respectively). Overall, 81.6% of patients responded to treatment, while 18.4% required diversion colostomy. Treatment success did not differ significantly between groups (p = 0.897). The mean time to full remission was 6.33 ± 2.426 days. Average hospital stay was 9.89 days in the normal saline group and 8.43 days in the vancomycin group (p = 0.071).
Conclusion: Vancomycin enemas do not offer a significant advantage over normal saline enemas in symptom resolution or hospital stay for patients with HAEC.
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Copyright (c) 2026 Ameer, Farah Mushtaq (Author)
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