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Hirschsprung disease — RACP Paediatrics MCQ

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HardGastroenterologyHirschsprung diseaseRACP Paediatrics

A term neonate passed meconium at 60 hours and has recurrent abdominal distension. At 3 weeks he presents with bilious vomiting; rectal examination is followed by explosive stool. Abdominal X-ray shows distal bowel obstruction. What is the most appropriate investigation?

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

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Correct answer: B — Rectal suction biopsy

Delayed meconium passage, distal obstruction and explosive stool after rectal examination suggest Hirschsprung disease. Rectal suction biopsy demonstrates absence of ganglion cells and confirms the diagnosis. Contrast enema can support assessment but biopsy is definitive.

Reference: RCH Constipation guideline; RACP Knowledge Guides