Differential Diagnosis

  • Aya Tanaka
  • Ryuichi ShimonoEmail author


Symptoms of Hirschsprung’s disease (HD) in neonates include abdominal distention, bilious vomiting, and impaired meconium excretion. Congenital intestinal obstruction or anorectal anomalies can cause mechanical intestinal obstruction with HD-like symptoms. Intestinal obstruction caused by delayed evacuation of meconium can be confused with HD, and food allergy may also cause HD-like symptoms. Chronic constipation is included in the differential diagnosis, but its symptoms appear at an older age compared with those associated with HD. Anamnesis, physical findings, and complementary evaluations such as abdominal plain X-ray and contrast enema imaging, anorectal manometry and suction, or surgical biopsy of patients can help differentiate HD from other conditions. Complementary evaluations are generally needed, but a definitive diagnosis may still be challenging in neonates.


Intestinal obstruction, Anorectal anomalies, Meconium-related disease, Chronic constipation, Allied-Hirschsprung’s disease 


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© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Department of Pediatric Surgery, Faculty of MedicineKagawa UniversityKita-gunJapan

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