Objectives

• Explain the criteria for establishing the diagnosis of Hirschsprung disease from a rectal biopsy.

• Understand the features of a transition zone in Hirschsprung disease.

• Understand how transition zone anatomy impacts intraoperative management of Hirschsprung disease.

To-do List

• Watch lesson videos

• Review histology slides

• Watch video review of histology slides

• Read articles

• Review and decide how you would diagnose each unknown case

• Watch unknown case explanatory video

Pre-Lesson Assessment:

Virtual lecture

Grossing Hirschsprung Specimens

Introductory histology slides (for review, no questions, click links)

• Normal colon (resection specimen)

• Aganglionic colon (resection specimen)

• Abnormal calretinin IHC

• Aganglionic frozen section

• Permanent section of aganglionic frozen section

Video explanation of introductory slides:

Reading Assignments

• Diagnosis of Hirschsprung disease

• Optional article (if you have access from your institution)

• Article (free access after October 1, 2020)

Unknown Case Slides: review the following and decide on your most likely diagnosis

• Case 1: Neonate, rectal biopsy

• Case 2: Neonate, rectal biopsy

• Case 3: Neonate, proximal portion of a resection specimen

• Case 4: Neonate, diagnosed with Hirschsprung disease. Frozen section from a pull through procedure 

• Case 5: Neonate, rectal biopsy

Unknown Case Explanation Video

Post-module assessment:

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