Clinical Impression: Hirschsprung disease

• Hirschsprung disease should be considered in any newborn

with delayed passage of meconium. Other symptoms
include bowel obstruction with bilious vomiting, abdominal
distention, poor feeding, and failure to thrive.
• The classic finding of Hirschsprung disease is a narrowed
distal colon with proximal dilation; and do not demonstrate
this transition zone in approximately 25% of the time. 
• Retention of rectal contrast for longer than 24 hours after
the barium enema also suggests a diagnosis of
Hirschsprung disease.
• The definitive diagnosis of Hirschsprung
disease is confirmed by a full-thickness rectal
biopsy demonstrating the absence of ganglion
cells.