An 11-year-old girl presents to your clinic with a history of chronic constipation. She underwent a Duhamel procedure for Hirschsprung disease when she was a newborn. Previous transition zone was identified in the proximal-descending colon based upon review of medical records. She is markedly underweight and has been undergoing regular rectal irrigation and disimpaction. An abdominal film and contrast enema were obtained. Examination under anesthesia does not reveal a retained Duhamel spur. What is the best next step in the management of this patient?
a Diverting ostomy
b Revision Duhamel
c Rectal irrigation/disimpaction
d Revision Swenson
e Revision Soave
a Diverting ostomy
b Revision Duhamel
c Rectal irrigation/disimpaction
d Revision Swenson
e Revision Soave
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