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]

B rectal biopsy

B

B full thickness biopsy

This x-ray give me that this child suffered from Idiopathic constipation from the being not HD,I plan for BMP with laxative,Or it could be a residual ganglionic segment in this case a biopsy at the site if anastomosis is indicated for an expert histopathologist in Hd.Thanks.

Full thickness rectal biopsy

A: patient need to evacuate his bowel and clean it. No sign suggesting HD

thanks for explanation

correct answer : B Full thickness rectal biopsy

 

to exclude residual aganglionic segment

B, rectal biopsy