Question

You are trying to differentiate between functional constipation and Hirschsprung's disease in a neonate. Distinguishing features of Hirschsprung's disease includes which of the following?

1) Abdominal distension
2) Ribbon-like stools
3) Failure to pass meconium within 48 hours of birth
4) All of the above

Answer 1

To distinguish Hirschsprung's disease from functional constipation in a neonate, look for features like abdominal distension, ribbon-like stools, and notably, failure to pass meconium within 48 hours of birth, which is a key sign of Hirschsprung's disease.

Step-by-step explanation:

When differentiating between functional constipation and Hirschsprung's disease in a neonate, certain distinguishing features of Hirschsprung's disease are observed, including:

1. Abdominal distension
2. Ribbon-like stools
3. Failure to pass meconium within 48 hours of birth
4. All of the above

Hirschsprung's disease is a congenital condition marked by an absence of nerve cells (ganglion cells) in segments of the bowel, resulting in a lack of movement (peristalsis) in that segment, which causes blockage and expansion of the bowel. This can lead to symptoms like abdominal distension, problems passing stool, and can be as severe as failure to pass meconium.

Meconium, which is usually a black, tarry substance that is the newborn's first stool, typically should be passed within the first 48 hours of life. A delay or failure to pass meconium is a significant indicator of Hirschsprung's disease, and a neonate with such symptoms should be evaluated by a healthcare provider immediately.