Hirschsprung disease

Case contributed by Aneta Kecler-Pietrzyk
Diagnosis certain

Presentation

Ongoing extreme constipation (obstipation) and abdominal pain.

Patient Data

Age: 10 years
Gender: Male
Barium

First image is a spot image from initial fluoroscopy of large bowel barium demonstrating narrowing of rectum and proximal pooling of contrast.

Repeat radiograph 24 hours later shows retention of contrast.

Case Discussion

Hirschsprung disease is typically diagnosed shortly after birth.

In rare cases, it may develop gradually, presenting with non-specific symptoms such as constipation and abdominal pain, as in this case.

Suction rectal biopsy confirmed a lack of ganglionic nerve cells consistent with Hirschsprung disease.

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