Case Discussion

Patient History: A newborn male infant, delivered at full term with an uneventful birth and
neonatal period, is brought to the pediatric clinic by his mother. The main concern is
constipation, which has been noted since birth. The mother reports that the baby has not
passed stool regularly, and when he does, it is accompanied by significant straining. Despite
these issues, the infant's growth and feeding patterns appear normal. There is no known family
history of gastrointestinal disorders.

Physical Examination: Upon examination, the newborn appears well and is in good general
health. However, the abdominal examination reveals distension, and a digital rectal examination
demonstrates an empty rectum. No abnormal masses are palpable.

QUESTIONS:

1. Review in general the normal histology of the layers of the digestive tract.

2. Differentiate Meissner’s from Myenteric plexuses.

.
3. What is the embryological etiology of Hirschsprung's disease. Discuss briefly.

4. Why is rectal biopsy considered the gold standard for diagnosing

Hirschsprung's disease?

5. What specific histological findings are characteristic of Hirschsprung's disease

on rectal biopsy?

6. Describe the differences between the affected and unaffected segments in

terms of ganglion cells.

7. What findings would you expect on a barium enema in a patient suspected of

having Hirschsprung's disease? What do these findings suggest? Explain
briefly.

8. What are the common treatment options for Hirschsprung's disease?

9. What complications can arise if Hirschsprung's disease is not diagnosed and

treated promptly?