Abstract
We present the case of a child with presumed total colonic Hirschsprung disease (HD)
to highlight the problems the surgeon is likely to encounter if he/she relies on the
appendix alone for histopathologic diagnosis. A newborn male infant, who was presumed
to have total colonic aganglionosis when the appendix was found to be aganglionic
at the time of initial exploratory laparoscopy, was managed with an ileostomy in the
newborn period; however, at the time of his planned pull-through procedure, the rectal
biopsy revealed normal ganglion cells. The child was subsequently managed with ileostomy
closure and observed for normal feeding and stooling prior to discharge home. We discuss
the histopathologic findings of the appendix in separate cases of confirmed total
colonic HD seen in our center, and review the normal histopathologic findings of the
appendix.
Keywords
appendix - histopathology - Hirschsprung
