Playing from Playbook #233
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Marc Levitt

Pediatric Surgery · View profile →

Colorectal Quiz: Episode 46 - Hirschsprung's Disease

Video Published 2026-07-29 Updated 2026-07-31

Topic Overview

Expert panel discusses diagnostic approach and surgical management of Hirschsprung disease in a neonate with Trisomy 21, covering biopsy techniques, pull-through timing, and stoma selection. Emphasizes individualized surgical planning and long-term sphincter management strategies for optimal outcomes.

Key Takeaways

  • Trisomy 21 patients with bilious emesis and delayed meconium passage require prompt workup for Hirschsprung's disease
  • Full-thickness rectal biopsies are essential to confirm aganglionosis and guide surgical planning
  • Mapping biopsies during surgery determine the extent of disease and whether colostomy versus ileostomy is needed
  • Botox injection for internal sphincter relaxation can improve long-term continence outcomes in select patients
  • Family education on home rectal irrigations is critical for postoperative management and preventing enterocolitis

Keywords

Hirschsprung Disease Pediatric Surgery Aganglionosis Pull-through Procedure Trisomy 21 Rectal Biopsy Neonatal Bowel Obstruction

Hashtags

#HirschsprungDisease #PediatricSurgery #ColorectalSurgery #NeonatalCare

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