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April 17, 2025 30 mins

In this episode of the Colorectal Quiz, Drs. Marc Levitt, Jason Frischer, Kristy Rialon, and Lily Cheng explore the diagnostic and surgical challenges of Hirschsprung disease, featuring a neonatal patient with Trisomy 21. Through a step-by-step case discussion, they highlight how early recognition, biopsy strategy, and patient-specific surgical planning can dramatically improve outcomes.

Key Highlights:

  • Patient Case Study: A newborn with Trisomy 21, bilious emesis, and delayed meconium passage sparks a thorough workup for Hirschsprung disease.
  • Diagnosis: The team breaks down how rectal irrigations and full-thickness biopsies confirm aganglionosis and rule out other causes.
  • Surgical Strategy: A discussion on when to perform a pull-through, mapping biopsies, and choosing between colostomy and ileostomy.
  • Long-Term Management: Addressing the role of Botox for internal sphincter relaxation and educating families on home care and irrigations.

This episode emphasizes the value of thoughtful, team-based decision-making and patient-tailored care in managing Hirschsprung disease. Don’t forget to download the StayCurrentMD app to view supporting visuals and expert resources—and subscribe for more pediatric surgery insights!

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