How can we determine diagnosis of what looks like hirschprung's disease?

Biopsy: For infants, rectal suction biopsy is appropriate. For older children, full thickness surgical biopsy is needed.

Study and biopsy: A low segment barium enema will outline the colon and any typical features of hirschsprung's disease. The gold standard is rectal biopsy looking for microscopic ganglion cells. Absence of these ganglion cells is suggestive of hd.

Symptoms, BE, and bx: Hirschsprung’s disease caused by failed migration of colonic ganglion cells in utero. Can vary from very short segment to entire large bowel. Obstruction noted usually in infancy with delayed passage of meconium.Sometimes recognition is later due to intractable constipation. Dx usually with barium enema and possible biopsy of rectum.