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Image of the Day
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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.
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SOURCE: Atlas of Pediatric Emergency Medicine
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