Hirschsprung disease

Case contributed by Dr Erik Ranschaert

Presentation

Vomiting and no meconium loss.

Patient Data

Age: 2 days

Distended (small) bowel loops filled with air, no air in the rectum.

Enema with water-soluble contrast

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.

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