A newborn is being evaluated for Hirschsprung's disease.Which findings support this diagnosis? Select all that apply.
Explanation & Rationale
A. Poor feeding: Infants with Hirschsprung’s disease often have difficulty feeding due to functional intestinal obstruction. Poor feeding is a common early symptom caused by impaired colonic motility. B. Failure to pass meconium within the first 2 hours after delivery: Delayed meconium passage in Hirschsprung’s disease typically means failure to pass stool within the first 24–48 hours. Failure within just 2 hours is not a reliable diagnostic sign. C. Abdominal distention: Accumulation of stool and gas above the aganglionic segment leads to progressive abdominal swelling. This is a classic presentation in infants with Hirschsprung’s disease. D. Projectile nonbilious vomiting after feeds: Projectile nonbilious vomiting is more characteristic of pyloric stenosis, where the obstruction is above the bile duct entry. It is not a typical finding in Hirschsprung’s disease. E. Bilious vomiting: Obstruction in the distal intestine, as seen in Hirschsprung’s disease, often results in bilious vomiting. This is because bile mixes with gastric contents before being obstructed.