Muntadhar Muhammad Isa, Dian Adi Syahputra, Teuku Yusriadi, Yumna Muzakkir, Gunadi, Reno Keumalazia Kamarlis, Zulham Effendy
Introduction: Full-thickness rectal biopsy (FTRB) is conventionally performed to obtain tissue for identifying aganglionic segments in Hirschsprung disease. This procedure is technically similar to the posterior rectal myectomy, which has been reported to be beneficial in patients with short-segment Hirschsprung disease. In this report, we aim to describe a case series of three babies with chronic constipation since birth who demonstrated clinical improvement following FTRB. Case series: Three baby with suspected HSCR presented with chronic constipation and abdominal distension since the first days of life. The patients were aged 65 days (weight 6,000 g), 35 days (weight 6,200 g), and 35 days (weight 4,100 g). Radiological evaluation included plain abdominal radiography and water-soluble contrast enema, which revealed colonic dilatation with features suggestive of a transition zone. All patients underwent anal examination under general anesthesia to exclude anatomical anorectal abnormalities prior to biopsy. A FTRB was performed using an elliptical incision, with the proximal extent of the biopsy located approximately 6 cm above the dentate line. Histopathological using hematoxylin and eosin staining confirmed aganglionosis in all cases. Postoperatively, all patients showed clinical improvement, with spontaneous daily bowel movements observed by postoperative day two to three and resolution of abdominal distension. Conclusion: FTRB by elliptical incision extends from the serosal to the muscular layers and may relieve non-relaxing aganglionic segments in short-segment Hirschsprung disease. Apart from its diagnostic role, FTRB may serve a therapeutic role in selected cases, warranting further evaluation in larger studies. © 2026 Universiti Putra Malaysia Press. All rights reserved.
Pediatric Surgery Division, Department of Surgery, Universitas Syiah Kuala, Dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia; Pediatric Surgery Division, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia; Department of Pathology Anatomy, Faculty of Medicine, Universitas Syiah Kuala, Dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia; Department of Surgery Faculty of Medicine, Universitas Syiah Kuala, Dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia
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