Paediatric imaging: Hirschsprung disease: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Paediatric imaging: Hirschsprung disease

Sample item

A newborn with delayed passage of meconium and abdominal distension has a contrast enema showing a narrow rectum with a conical transition zone and a dilated sigmoid colon. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Hirschsprung disease

Absence of ganglion cells makes the distal bowel spastic and narrow with a funnel-shaped transition to dilated normal bowel proximally. The retained contrast at 24 hours supports the diagnosis. Rectal biopsy confirms by absent ganglion cells.

Option by option

  • A. Anorectal malformation

    Anorectal malformation is noted on examination with an absent anal opening.

  • B. Necrotising enterocolitis

    NEC shows pneumatosis intestinalis in a premature baby.

  • C. Hirschsprung disease (correct)

    Correct. A narrow aganglionic segment with a transition zone indicates Hirschsprung disease.

  • D. Meconium plug

    A meconium plug shows filling defects and clears after the enema.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is C, Hirschsprung disease. Absence of ganglion cells makes the distal bowel spastic and narrow with a funnel-shaped transition to dilated normal bowel proximally.

Why is "Anorectal malformation" not the answer?

Anorectal malformation is noted on examination with an absent anal opening.

Why is "Necrotising enterocolitis" not the answer?

NEC shows pneumatosis intestinalis in a premature baby.

Why is "Meconium plug" not the answer?

A meconium plug shows filling defects and clears after the enema.

What concept does this question test?

It tests Paediatric imaging: Hirschsprung disease in Radiology. The retained contrast at 24 hours supports the diagnosis. Rectal biopsy confirms by absent ganglion cells.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric imaging: Hirschsprung disease?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.