Treating Hirschsprung's disease requires surgery to remove the
affected bowel and then join the healthy bowel segments. There
are three different approaches, each with a high rate of
success. The choice depends on the overall health of the child
and the training and experience of the surgeon Sometimes a
single surgical procedure is recommended to remove the
aganglionic segment , then bring the healthy bowel down into the
rectum , and join it to the rectal wall : this is called a
"pull-through . If an infant is too small or a child is
critically ill, a temporary colostomy may be necessary prior to
the pull-through. In a colostomy, the colon is brought out to
the surface of the abdomen so that stool contents can be
discharged into a special bag for disposal Subsequent to the
colostomy, the pull-through surgery can be planned. The
colostomy opening can then closed at the time of the pull-
through, or, in some cases, at a third operation after it is
clear that the pull-through is working. For most children with
Hi