Newborn with failure to pass meconium and bilious vomiting

Surgical image of Hirschsprung disease
Surgical image shows a transition zone in the terminal ileum with the proximal portion of the small bowel above the transition zone dilated (on the right) and the non dilated distal small bowel (on the left). The frozen biopsies showed no ganglion cells from the rectum all the way up to the terminal ileum.

The diagnosis was total colonic Hirschsprung disease.