EXAM: Fluoroscopic enema (water-soluble contrast enema)
INDICATION: 4-day-old male with failure to pass meconium.
TECHNIQUE: Multiple fluoroscopic images were obtained during the retrograde infusion of water-soluble contrast per rectum and into the colon.
FINDINGS:
Fluoroscopic images show contrast filling the rectum and distal colon. The rectum is abnormally narrowed and does not dilate appropriately even on delayed imaging. The caliber of the distal sigmoid colon is larger than the rectum and there is an abrupt rectosigmoid transition. More proximal loops of colon are dilated. Small filling defects are seen in the dilated colon.
IMPRESSIONS:
1. Narrow-caliber rectum, with abrupt transition and abnormal rectosigmoid index, suggestive of Hirschsprung disease. Recommend suction biopsy to further evaluate.
2. Dilated proximal colonic loops, with filling defects likely representing retained meconium.
