Paediatric surgery: Hirschsprung enterocolitis: practice question

A General Surgery 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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General Surgery · Paediatric surgery: Hirschsprung enterocolitis

Sample item

A neonate with Hirschsprung disease develops fever, explosive foul-smelling diarrhoea and abdominal distension with lethargy. What is the diagnosis and treatment?

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

The answer and the reasoning

C. Hirschsprung-associated enterocolitis; resuscitation, antibiotics and rectal washouts

Enterocolitis is the major cause of death in Hirschsprung disease and may occur before or after pull-through. Treatment is resuscitation, broad-spectrum antibiotics, bowel decompression by rectal irrigation, and definitive pull-through. RET mutations are the commonest genetic association.

Option by option

  • A. Gastroenteritis; oral rehydration only

    This is not simple gastroenteritis.

  • B. Appendicitis; appendicectomy

    Appendicitis is rare in neonates.

  • C. Hirschsprung-associated enterocolitis; resuscitation, antibiotics and rectal washouts (correct)

    Correct. Enterocolitis needs urgent treatment.

  • D. Intussusception; air enema

    Intussusception does not explain explosive diarrhoea in known Hirschsprung disease.

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 General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Hirschsprung-associated enterocolitis; resuscitation, antibiotics and rectal washouts. Enterocolitis is the major cause of death in Hirschsprung disease and may occur before or after pull-through.

Why is "Gastroenteritis; oral rehydration only" not the answer?

This is not simple gastroenteritis.

Why is "Appendicitis; appendicectomy" not the answer?

Appendicitis is rare in neonates.

Why is "Intussusception; air enema" not the answer?

Intussusception does not explain explosive diarrhoea in known Hirschsprung disease.

What concept does this question test?

It tests Paediatric surgery: Hirschsprung enterocolitis in General Surgery. Treatment is resuscitation, broad-spectrum antibiotics, bowel decompression by rectal irrigation, and definitive pull-through. RET mutations are the commonest genetic association.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 surgery: Hirschsprung enterocolitis?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.