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Hirschsprung's disease (Clinical
presentation (Failure to pass
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Hirschsprung's disease
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Pathophysiology
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Results in narrow, contracted
segment of colon
Extends from rectum, can go all the way along the colon or to the stomoch (rare)
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Diagnosis
Examination
Abdo: distended, may be tender
PR: may show narrow segment with
gush of fluid and flatus on removal of finger
Investigations
Bedside: obs (nil)
Bloods: FBC, CRP/ESR, U+E, LFT (all nil)
Imaging: colonoscopy + biopsy (absent ganglion cells, stain for ACh +ve nerve excess),
contrast studies (length of anganglionosis)
History
Delayed meconium passage,
signs of obstruction (bloating, tenderness,
reduced bowel motions), green vomit
Management
Conservative
Information, advice, support
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