Hirschsprung Disease in the Older Child

BACKGROUND: Hirschsprung disease is usually diagnosed in patients who are younger than 1 year; but in some individuals it is found later in childhood. OBJECTIVE: This retrospective study is focused on clinical signs and symptoms of Hirschsprung disease in older children. MATERIALS AND METHODS: Patients with Hirschsprung disease were included in the study if they were older than 14 months at the time of diagnosis. RESULTS: Ten patients older than 14 months were diagnosed with Hirschsprung disease; 7 were males and 3 females. In all, 60% had a positive history of recurrent gastrointestinal infection with vomiting and hospitalization. In 6 patients, the final diagnosis was delayed because of unspecific findings in contrast enema. Rectal biopsy confirmed the diagnosis in all patients. CONCLUSION: Contrast enema is not a specific method for diagnosing Hirschsprung disease. Rectal biopsy alone confirms the diagnosis and provides a clear indication for surgery.