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Hirschsprung Disease — RACP Paediatrics MCQ

Instant feedback + full explanation. One question, done properly.

HardGastroenterologyHirschsprung DiseaseRACP Paediatrics

A 6-week-old awaiting definitive surgery for Hirschsprung disease develops fever, explosive foul diarrhoea, abdominal distension and lethargy. Abdominal radiography shows dilated bowel without perforation. Which treatment bundle should start?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Give fluids, antibiotics and rectal washouts with surgical consultation

Explanation lettering: C = shown as B · D = shown as C · B = shown as D

B is correct. The presentation is Hirschsprung-associated enterocolitis, which requires urgent resuscitation, broad antimicrobial treatment, rectal washouts/decompression and paediatric surgical involvement. A under-treats a potentially fatal complication. C bowel preparation and colonoscopy risk deterioration and delay treatment. D antimotility therapy worsens obstruction. E enteral feeding is inappropriate during acute distension and systemic illness.

Reference: RCH Melbourne, Hirschsprung-associated enterocolitis: https://www.rch.org.au/clinicalguide/guideline_index/Hirschsprung_associated_enterocolitis_HAEC/