Hirschsprung’s disease (HD) is one

Hirschsprung’s disease (HD) is one of the most common surgical diseases in the paediatric age group with an incidence of approximately 1 in 5,000 live births.[1] It is a congenital condition characterized by the absence of parasympathetic ganglion cells in the submucosal (Meissner’s) and myenteric (Auerbach’s) plexuses of the distal bowel. This leads to a functional intestinal obstruction presenting with delayed passage of meconium in the newborn or recurrent constipation in the older child with failure to thrive. The aganglionosis usually involves the anus and a variable portion of the large bowel. Rarely, the disease extends to involve the small bowel or even the whole of the intestine.[2] Some patients may present with enterocolitis-related diarrhoea and many untreated cases of HD usually die in their infancy from this complication.[3] Barium enema may help with diagnosis but the classical transition zone may not be obvious in the first three months.[4] Rectal biopsy remains the gold standard in confirming HD and it shows absence of ganglion cells and presence of hypertrophied nerve fibres.