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View Large View in Context Figure 15-14. Hirschsprung's Disease A. Abdominal distension is seen in this 10-year-old boy who presented with abdominal pain, vomiting, and a chronic history of constipation since 3 weeks of age. He had a very protuberant abdomen with a palpable abdominal mass (shown by the marks) in the left lower quadrant. He had received numerous enemas and suppositories in various EDs, including two prior hospitalizations (ages 6 and 9) for fecal impaction. He was supposed to undergo a rectal biopsy but missed several appointments at the GI clinic. B. This frontal radiograph of the abdomen in the same patient shows gross dilation of the rectum and sigmoid colon secondary to distal rectal obstruction. Also seen is mild dilation of more proximal colonic loops. A rectal biopsy confirmed the diagnosis of an aganglionic segment in the rectosigmoid region.

SOURCE: Atlas of Pediatric Emergency Medicine

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Textbooks

	Tintinalli's Emergency Medicine: A Comprehensive Study Guide Tintinalli, Kelen, & Stapczynski
	Emergency Medicine Manual Ma, Cline, Tintinalli, Kelen, & Stapczynski
	Emergency Medicine Procedures Reichman & Simon
	Emergency Ultrasound Ma, Mateer, & Blaivas
	Pediatric Emergency Medicine Strange, Ahrens, Lelyveld, & Schafermeyer
	Obstetric and Gynecologic Emergencies: Diagnosis and Management Pearlman, Tintinalli, & Dyne
	Emergency Orthopedics Simon, Sherman, & Koenigsknecht
	Atlas of Emergency Medicine Knoop, Stack, & Storrow
	Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology Wolff, Johnson, & Suurmond
	Atlas of Pediatric Emergency Medicine Shah & Lucchesi
	Goldfrank's Manual of Toxicologic Emergencies Hoffman, Nelson, Howland, Lewin, Flomenbaum, & Goldfrank
	Infectious Diseases: Emergency Department Diagnosis & Management Slaven, Stone, & Lopez
	Emergency Radiology: Case Studies Schwartz