Paediatric Surgery

Question 1

Define Hirschsprung’s Disease

Answer 1

Congenital colonic aganglionosis which causes a physiological obstruction and enlargement of the colon

Question 2

Describe the pathophysiology of Hirschsprung’s disease

Answer 2

It is the absence of Auerbach’s plexus and Meissner’s plexus and therefore there is a defect in smooth muscle relaxation, blood flow, absorption and secretion

It usually starts at the anus and extends approximately mainly involving the rectum and distal sigmoid

Question 3

List the signs and symptoms of Hirschsprung’s disease

Answer 3

No meconium passed

Constipation followed by diarrhoea

PR exam is normal until finger is withdrawn and results in explosive diarrhoea

Abdominal distension

Question 4

What would you expect to see on abdominal x-ray of Hirschsprung’s disease

Answer 4

Enlarged colon with faeces

Question 5

How is Hirschsprung’s disease managed

Answer 5

Bowel resection and anastomoses