Hirschsprung

Hirschsprung

Normally, little nerves (ganglion cells) tell the intestine:
👉 “Squeeze and push the poop along!”

In Hirschsprung disease, a part of the intestine is born without those nerve cells. That part cannot relax and move poop properly.

So:

No nerve cells → poop can’t move → poop backs up → belly gets swollen.

Nclex key point

NCLEX KEY POINTS

• Congenital — baby is born with it.

• ⭐ Classic finding: newborn does NOT pass meconium within 24–48 hours.

• Abdominal distention

• Constipation

• Bilious (green) vomiting

• Poor feeding

• May have explosive stool after a rectal examination

• Rectal biopsy confirms the diagnosis → shows absence of ganglion cells.

• Definitive treatment = surgery (pull-through procedure) to remove the affected bowel and connect healthy bowel.

Major NCLEX Complication: Enterocolitis

Watch for:
Fever + worsening abdominal distention + foul/watery diarrhea + lethargy.

This can become life-threatening and needs immediate treatment.

Easy Memory Trick

HIRSCHSPRUNG = “Poop can’t SPRING out.” 💩

Think:

No GANGLION → No GOING 💩

❓ NCLEX Question Clue

If you see:

Newborn + hasn’t passed meconium for 48 hours + swollen abdomen + green vomiting

👉 Think HIRSCHSPRUNG DISEASE.