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The following is a summary of “Swenson-like pull-through for treatment of the rare association between Hirschsprung’s disease and anorectal malformation,” published in the March 2025 issue of BMC Pediatrics by Abdelmalak et al. 

Anorectal malformations and Hirschsprung’s disease are rare co-occurring congenital disorders. This association occurs in 2–3% of ARM cases. 

Researchers conducted a retrospective study on three cases of Hirschsprung’s disease with anorectal malformation.  

They analyzed 5 patients with ARM and HD diagnosed through clinical and radiological evaluations, confirmed by rectal biopsy. A Swenson-like pull-through was performed after ARM repair, with anastomosis created 3 cm from the anal verge instead of 3 cm from the dentate line. 

The results showed that among 136 patients with ARM treated over 5 years, 5 had concurrent HD. In 3 cases, HD was diagnosed after ARM repair, and they underwent a Swenson-like pull-through. Of 2 achieved good bowel control, while one had regular bowel movements with occasional enterocolitis. The other 2 were diagnosed after colostomy, leading to a different approach. 

Investigators emphasized the need to consider HD in patients with ARM and persistent symptoms after repair. Preservation of the aganglionic neoanal canal with Swenson pull-through improved postoperative continence. 

Source: bmcpediatr.biomedcentral.com/articles/10.1186/s12887-025-05549-0