ABSTRACT
Hirschsprung’s disease should be considered in neonates presenting with abdominal distension, delay in passing meconium, and bile vomiting, and in the older child with intractable constipation. Although the diagnosis may be suggested by a contrast enema showing the ‘transitional zone’ or by anorectal manometry, it can only be established with certainty by histologic examination of the affected, aganglionic bowel wall. This can be achieved most easily by obtaining a biopsy of the mucosa and, most importantly, the submucosa of the rectum.
