Colorectal Quiz Episode 3: Hirschsprung Disease
Topic overview
In the third episode of the Colorectal Quiz series, Dr. Levitt and Dr. Frischer discuss the basics of the initial management and diagnosis of Hirschprung disease.
2 view abdominal XR
Contrast enema
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Key takeaways
- Hirschsprung disease presents with delayed meconium passage and abdominal distension in neonates requiring prompt evaluation
- Contrast enema showing transition zone and rectal suction biopsy are key diagnostic tools for confirming aganglionosis
- Initial management includes rectal irrigations to decompress the colon and prevent enterocolitis before definitive surgery
- Recognition of enterocolitis signs (fever, bloody diarrhea, distension) is critical as it represents a surgical emergency
- Definitive treatment is pull-through surgery, typically performed after initial stabilization and diagnostic confirmation
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