What are the key clinical features to consider when diagnosing Hirschsprung's disease in infants?

Key clinical features to consider when diagnosing Hirschsprung's disease in infants include:

• Delayed passage of meconium beyond 48 hours after birth, which is a hallmark early sign raising suspicion for Hirschsprung's disease ¹.
• Chronic constipation or failure to pass stools, often accompanied by abdominal distension and vomiting, indicating bowel obstruction ¹.
• Palpable abdominal distension and a tight, empty rectum on digital rectal examination, which may produce explosive release of stool and gas upon withdrawal, known as the "squirt sign" ¹.
• Signs of enterocolitis such as fever, diarrhea, and lethargy, which can complicate the disease and require urgent attention (Gorbatyuk, 2022).
• Failure to thrive or poor weight gain due to chronic bowel dysfunction (Matsukuma et al., 2023).
• In some cases, a family history of Hirschsprung's disease or associated syndromes (e.g., Down syndrome) may be present, supporting the diagnosis ¹.

These clinical features, combined with diagnostic investigations, guide the diagnosis of Hirschsprung's disease in infants ¹.