ABSTRACT
The classic approach to the neonate diagnosed with Hirschsprung disease had been to perform a leveling colostomy and to wait until 6–12 months of age to perform the definitive pull-through. This approach has changed dramatically over the past three decades, and transition to primary pull-through is now predominant. Suction rectal biopsy, because of its relative ease and low morbidity, has become the most established diagnostic tool for the Hirschsprung disease. Nevertheless, full-thickness rectal biopsies are occasionally required, and the technique of full-thickness biopsy is presented to assist surgeons who are not familiar with the procedure. Typically, the diagnosis of Hirschsprung disease can be suspected based on the history alone, but confirmation is required by the histopathologic examination of a rectal biopsy. The infant should receive rectal washouts, and the broad-spectrum IV antibiotics should be given just prior to the incision.
