Hirschsprung´s Disease vs. Biliary Atresia
Left picture: The clinical diagnosis is an obstructive ileus of the newborn due to Hirschsprung´s disease. Right picture: Here, the diagnosis is a biliary atresia.
The newborn, who is already suckled, and the 2-month-old infant have both a very large belly. Notice the level of the abdomen and its portion of trunc volume in relation to the chest. Left picture: The large belly is projecting to the side. The skin color is slightly yellow. Right picture: The abdomen is protruding semispherically and is tense with a broad navel; the skin color is actually dirty-yellow. Left picture: The insertion of a rectal tube leads to an evacuation of yellowish stool masses and winds followed by a diminution of the large belly as shown in the picture at the bottom on the corresponding side. This would not be possible in the infant in the contralateral picture. The picture at the bottom shows a stool specimen on a napkin of another child which looks like an acholic stool. Right picture: In the additional picture at the bottom a colorless grey or only slightly colored stool is spontaneously evacuated; the large abdomen is not caused by a stool and wind retention, but by ascites and hepatosplenomegaly.