weekly_question 20/9/2020

[Admin]

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.



What is the best next step in management?

A Appendicostomy

B Full thickness rectal biopsy

C Colostomy

D Internal sphincterotomy

E Rectosigmoid resection

[Admin]

correct answer : B Full thickness rectal biopsy

to exclude residual aganglionic segment

[Mohamed Abd elsalam]

B rectal biopsy

[Basemsaed]

B

[Arwa]

B full thickness biopsy

[Farid Elallaghi]

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.

[Admin]

thanks for explanation

[Magdilolah]

Full thickness rectal biopsy

[Aey]

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

[Admin]

correct answer : B Full thickness rectal biopsy

to exclude residual aganglionic segment

[Salim Masadeh]

B, rectal biopsy