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November 1983

Rectal Prolapse in Two Neonates With Hirschsprung's Disease

Am J Dis Child. 1983;137(11):1126-1127. doi:10.1001/archpedi.1983.02140370082027

Hirschsprung's disease results from the congenital absence of ganglion cells in the myenteric plexus in a segment of intestine that extends proximally from the anus.1 In the neonatal period, the history and physical examination findings include delayed passage of meconium, constipation, abdominal distention, bilious emesis, and an empty rectum.2 Rectal prolapse, to our knowledge, has not been reported as an early clinical finding in Hirschsprung's disease. We describe two neonates admitted within a four-month period with rectal prolapse who subsequently had Hirschsprung's disease confirmed by biopsy specimens.

Report of Cases.—Case 1.—A 3.3-kg female infant was born after an uncomplicated pregnancy. The initial neonatal course was complicated by indirect hyperbilirubinemia and passage of her first stool at 36 hours of age. No abdominal distention was noted. The patient was breast-fed and supplemented with an infant formula (Similac) at home. Her second stool was noted at 2 weeks