A newborn’s failure to pass meconium within the first 24 hours after birth may indicate which of the following?
A.
Abdominal wall defect
B.
Celiac disease.
C.
Intussusception
D.
Hirschsprung disease
The Correct Answer and Explanation is:
The correct answer is D. Hirschsprung disease.
Hirschsprung disease, also known as congenital aganglionic megacolon, is a condition where nerve cells (ganglion cells) are missing from a portion of the baby’s intestines. This absence of ganglion cells disrupts the normal movement of the intestines, particularly peristalsis, which is the coordinated contraction of the bowel to move stool through the digestive tract. Without these ganglion cells, the affected part of the bowel becomes paralyzed, and stool cannot pass through it.
One of the hallmark signs of Hirschsprung disease in a newborn is failure to pass meconium within the first 24 to 48 hours after birth. Meconium is the first stool a baby passes, and it is typically dark, sticky, and tar-like. In a healthy newborn, meconium is usually passed within the first 24 hours. However, in babies with Hirschsprung disease, the lack of normal bowel movement due to the absence of nerve cells in the bowel causes a delay or failure to pass meconium.
Other symptoms that may accompany Hirschsprung disease include abdominal distension, bilious vomiting, feeding difficulties, and constipation. As the condition progresses, if left untreated, it can lead to more severe complications such as enterocolitis, which is a life-threatening infection of the intestines.
In contrast:
- A. Abdominal wall defect refers to conditions like gastroschisis or omphalocele, where parts of the intestines protrude outside the body. These conditions typically present with visible external abnormalities rather than issues with passing meconium.
- B. Celiac disease is a gluten intolerance that affects nutrient absorption later in life but does not affect newborns in the first days of life.
- C. Intussusception occurs when a part of the intestine telescopes into another part, leading to obstruction. This typically presents later with signs like vomiting, abdominal pain, and bloody stools.
Thus, Hirschsprung disease is the most likely cause of a newborn’s failure to pass meconium.