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!