A 3-month-old male infant presents with a history of chronic constipation and abdominal distension. The mother reports that the baby has had difficulty passing stools since birth and often strains without success. She notes that the baby passed meconium over 48 hours after delivery. Over time, the baby’s abdomen has become more bloated, and he has episodes of vomiting after feeding. His growth has been below average for his age, and he is frequently irritable.

On examination, the infant has a distended abdomen with visible peristaltic waves. A rectal exam reveals an empty rectum, and after withdrawal of the finger, a rush of stool and gas is expelled. The infant is diagnosed with Hirschsprung’s disease, confirmed by a rectal biopsy showing the absence of ganglion cells in the affected segment of the colon.

The treatment plan includes surgical intervention to remove the aganglionic segment and restore normal bowel function.