Presentation
Failing to pass meconium.
Patient Data
Age: Neonate
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Supine abdominal film demonstrates numerous dilated loops of bowel, most likely down to the descending colon.
Some gas is seen in the pelvis, most likely in the rectosigmoid.
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Barium enema demonstrates a reduced caliber rectum and sigmoid (the rectum is smaller than the descending colon) with a saw-tooth appearance to the wall. A transition point is seen at the junction between sigmoid and descending colon.
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Post evacuation film demonstrates the transition point more obviously.
Case Discussion
These features are typical of short segment Hirschsprung disease.
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