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Colonic diverticulosis in an infant: a clue to total colonic Hirschsprung disease
Short SS, Pruitt LC, Rollins MD
J Pediatr Surg (2018) Mar 23. pii: S0022–3468(18)30206–9. https://doi.org/10.1016/j.jpedsurg.2018.03.017. [Epub ahead of print]
Hirschsprung disease (HD; colonic aganglionosis) is relatively common, but total colonic aganglionosis is a rare subtype that usually presents before 3 months of age. Diagnosing total HD on imaging is often challenging because, in addition to its rarity, it often has a nonspecific appearance on contrast enema. This can include a normal appearance, diminished haustral pattern, shortened length, ‘question-mark’ shape, or complete microcolon. The authors present a 9-month-old girl who presented with bilious vomiting and abdominal distension. Contrast enema demonstrated a normal rectosigmoid ratio. However, multiple right-sided colonic diverticula were also present, which is an unusual finding in a neonate. Because of this abnormality the patient...