Neonatology: Hirschsprung disease: practice question

A Pediatrics 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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Pediatrics · Neonatology: Hirschsprung disease

Sample item

A 3-week-old boy, who passed no meconium for 48 hours after birth, now has abdominal distension, fever and explosive foul-smelling diarrhoea after a rectal examination. What is the most likely complication?

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

The answer and the reasoning

A. Hirschsprung-associated enterocolitis

Delayed passage of meconium with distension suggests Hirschsprung disease, and enterocolitis is its most dangerous complication. It can occur before or after surgery and may lead to toxic megacolon. Rectal washouts and antibiotics are part of management.

Option by option

  • A. Hirschsprung-associated enterocolitis (correct)

    Correct. Distension, fever and explosive diarrhoea in aganglionosis indicate enterocolitis.

  • B. Meconium ileus

    Meconium ileus occurs in cystic fibrosis in the first days and does not follow a rectal examination with diarrhoea.

  • C. Intussusception

    Intussusception presents with colicky pain and red currant stool, mostly at 3 to 9 months.

  • D. Necrotising enterocolitis

    Necrotising enterocolitis typically affects preterm infants soon after starting feeds.

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.

More Pediatrics questions

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is A, Hirschsprung-associated enterocolitis. Delayed passage of meconium with distension suggests Hirschsprung disease, and enterocolitis is its most dangerous complication.

Why is "Meconium ileus" not the answer?

Meconium ileus occurs in cystic fibrosis in the first days and does not follow a rectal examination with diarrhoea.

Why is "Intussusception" not the answer?

Intussusception presents with colicky pain and red currant stool, mostly at 3 to 9 months.

Why is "Necrotising enterocolitis" not the answer?

Necrotising enterocolitis typically affects preterm infants soon after starting feeds.

What concept does this question test?

It tests Neonatology: Hirschsprung disease in Pediatrics. It can occur before or after surgery and may lead to toxic megacolon. Rectal washouts and antibiotics are part of management.

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 Neonatology: Hirschsprung disease?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.