مولود عمره ٣ أيام لم يُخرج العقي (أول براز) حتى الآن، وبطنه منتفخ، ويتقيأ صفراء. عند الفحص الشرجي خرج براز وغازات بقوة. ما الحالة المتوقعة؟

A 3-day-old newborn has not passed meconium, has a distended abdomen and bilious vomiting. On rectal examination stool and gas are expelled forcefully. What is the likely condition?

1. Intussusception
2. Hypertrophic pyloric stenosis
3. Infant gastro-oesophageal reflux
4. Hirschsprung disease

Answer: D) Hirschsprung disease. Failure to pass meconium within 48 hours, distension, bilious vomiting and explosive stool after rectal exam suggest Hirschsprung disease (absent ganglion cells in part of the colon), confirmed by biopsy.