Hirschsprung disease

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[size=20px]A six-month old male child undergoes a diverting colostomy for Hirschprung associated enterocolitis. Which of the following statements about colostomies is true? A colostomies have a prolapse rate of less than five percent B prolapse of the proximal stoma is common in a distal left colostomy C loop colostomies have a higher complication rate D transverse colostomies rarely have prolapse problems E mucus fistulas rarely prolapse[/size]

[size=20px]A four-year old boy presents with chronic constipation and numerous failed attempts at medical management. A contrast enema shows a markedly dilated colon. He undergoes a full thickness rectal biopsy with findings consistent with neuronal intestinal dysplasia (NID). The histopathology of NID is best characterized by A hypoplastic ganglion cells. B absence of ganglion cells. C small ganglia within the myenteric plexus. D giant ganglia within the submucosal plexus. E decreased acetylcholinesterase activity in the lamina propria.[/size]

First one with correct answer with justification win. [size=20px]A two-year old male presents with refractory constipation following an uncomplicated Soave endorectal pull through for Hirschsprung disease. The most likely indication for a redo pull through operation is A anastomotic stricture. B motility disorder. C twisted pull through. D tight muscular cuff. E aganglionosis.[/size]

First one with correct answer with justification win. [size=20px]A four-year old boy had a endorectal pull through for Hirschsprung disease as an infant. Since toilet training he has experienced increasing constipation with occasional encopresis. There is no stricture on exam or contrast enema, a repeat rectal biopsy shows ganglion cells are present and anorectal manometry reveals increased resting anal sphincter tone. Which of the following is the preferred next step in management of this Hirschsprung patient with constipation? A antegrade continent enema procedure B lateral internal sphincterotomy C redo pull through D biofeedback training E ultrasound…

First one with correct answer with justification win. [size=20px]In patients with Hirschsprung disease, during balloon distension of the rectum anorectal manometry will show A partial relaxation of the internal sphincter B elevated external sphincter pressure C failure of relaxation of the internal sphincter D inhibition of contraction of the internal sphincter E relaxation of the external sphincter[/size]

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correct answer will be submitted after 48 hrs A 2-year old boy with a history of endorectal pull-through for Hirschsprung Disease who was lost to follow-up presents with fecal soilage and incontinence. His abdomen is distended and rectal exam reveals no stricture, but hard stool in his rectal vault. Contrast enema is shown below. [size=20px]What is the best next step in management? A Appendicostomy B Full thickness rectal biopsy C Colostomy D Internal sphincterotomy E Rectosigmoid resection[/size]

Harald Hirschsprung;1888 ahrbuecher für Kinderheilkunde [center] [/center]