Archive Of Standardized Exam Questions: Hirschsprung Disease


This page is dedicated to organizing various examples of standardized exam questions whose answer is Hirschsprung disease. While this may seem a odd practice, it is useful to see multiple examples of how Hirschsprung disease will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.


Question # 1

A 1 day old 5 lb 8 oz boy has had progressive abdominal distention. He was born at 38 weeks gestation after an uncomplicated pregnancy and spontaneous vaginal delivery. After his birth he has had two episodes of bilious vomiting after feedings, and he still has not passed meconium. His abdomen is distended and firm with visible loops of bowel. There are no external hernias seen on the physical exam, and the anus is patent. Abodminla X-rays of show several dilated loops of bowel with air-fluid levels. A barium enema shows an abrupt change in the caliber of the midsigmoid colon from a normal size to a dilated bowel proximally. Immediately after the barium enema the patent has a large explosive bowel movement. What is the likely diagnosis?

Explanation = squirt sign after rectal enema =  Hirschsprung disease

Question # 2

A 2 month old male infant is brought to the clinic because of chronic constipation. He has clear abodminla distention, and a plain X-ray shows gas in dilated loops of bowel throughout the abdomen. A rectal exam is performed and is followed by the expulsion of stool and flatus. This remarkable reduced the abdominal distention. 

Explanation: squirt sign after rectal exam = Hirschsprung disease


Page Updated: 11.08.2016