Hirschsprung disease

Case contributed by Dr Hani Makky Al Salam

Presentation

Failing to pass meconium.

Patient Data

Age: Neonate

Abdominal x-ray

X-ray

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. 

Barium enema

Barium

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.

Annotated post evacuation film

Fluoroscopy

Post evacuation film demonstrates the transition point more obviously. 

Case Discussion

These features are typical of short segment Hirschsprung disease.

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