Snapshot A newborn infant has not passed meconium in 2 days. Distended abdomen is appreciated on exam. During digital rectal examination, gas and stool is explused. Distended loops of bowel and an absence of gas in the rectum is seen on abdominal radiography. Introduction Congenital megacolon login to view 1 more bullet Epidemiology Boys > girls (4:1) ETIOLOGY Pathogenesis login to view 6 more bullets Genetics login to view 1 more bullet Associated conditions login to view 5 more bullets Presentation Symptoms login to view 4 more bullets Physical exam login to view 3 more bullets Imaging Abdominal radiography login to view 2 more bullets Contrast enema – best initial test login to view 2 more bullets STUDIES Manometry login to view 1 more bullet Differential Imperforate anus Functional constipation Intussusception Duodenal atresia Meconium ileus DIAGNOSIS Gold standard diagnosis login to view 2 more bullets Treatment Supportive care Surgical resection login to view 2 more bullets Complications ↑ risk of enterocolitis login to view 1 more bullet Rupture Prognosis Very good Overall mortality < 1% Normal quality of life in most patients