Presentation
Vomiting and no meconium loss.
Patient Data
Age: 2 days
From the case:
Hirschsprung disease
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Distended (small) bowel loops filled with air, no air in the rectum.
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Enema with water-soluble contrast shows a rectosigmoid ratio <1 and impaction of meconium in the distal colon. After the enema, the baby lost meconium with some plugs.
Case Discussion
Enema with water-soluble contrast in a neonate with failure to pass meconium, demonstrates a reduced caliber of the rectum and sigmoid (the rectum is smaller than the descending colon). A transition point is seen at the junction between sigmoid and descending colon.
Findings are consistent with Hirschsprung disease.