Should we look for Hirschsprung disease in all children with meconium plug syndrome?

Multi-institutional study reveals significant variation in rectal biopsy utilization for meconium plug syndrome, with biopsy rates ranging 0-80% despite similar Hirschsprung disease prevalence (40.5% in biopsied patients). Early biopsy increased timely HD diagnosis by 35% per additional case, suggesting standardized screening protocols could reduce delayed diagnoses.