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ARTICLE TYPE : REVIEW ARTICLE

Published on :   31 Jan 2026, Volume - 2
Journal Title :   WebLog Journal of Radiology | WebLog J Radiol
Source URL:   weblog iconhttps://weblogoa.com/articles/wjr.2026.a3104
Permanent Identifier (DOI) :  doi iconhttps://doi.org/10.5281/zenodo.18500977

Radiological Imaging in Hirschsprung’s Disease, Its Variants, and Colorectal Motility Disorders: A Comprehensive Review of Diagnostic Findings and Interventional Applications

Zaparackaite I 1
Govani ND 2
Singh H 3
Singh SJ 4
Mehta AR 5
Midha PK 5
Patel R 2
Patel RV 2 *
1Consultant Surgeon, Department of Pediatric Surgery, Emergency’s Children’s Surgical Hospital, Entebbe, Uganda and Evelina Children’s Hospital, London
2Department of Pediatric Surgery, PGICHR and KTCGUH, Rajkot 360001, Gujarat, India
3Care Gastroenterology Medical Group, California, USA
4Department of Pediatric Surgery, Nottingham University Hospitals, Nottingham, UK
5J. Watumull Global Hospital & Research Centre, Delwara Road, Mount Abu, Rajasthan 307501, India Affiliated to Medical Faculty of God Fatherly Spiritual University, Mount Abu, Rajasthan, India

Abstract

Objectives: To synthesize current evidence on radiological imaging modalities used in the assessment of Hirschsprung’s disease (HD), its variants, pseudo-Hirschsprung’s conditions, and colorectal motility disorders, highlighting characteristic findings, diagnostic pathways, and interventional procedures.

Design: Narrative review of radiological techniques and their diagnostic utility in congenital and acquired colorectal dysmotility syndromes.

Methods:

Data Sources: Peer-reviewed literature, clinical guidelines, and radiological case series retrieved from PubMed, Radiopaedia, and institutional imaging protocols.

Eligibility Criteria: Studies and reviews describing imaging findings in HD (short-segment, long segment, total colonic aganglionosis, ultrashort segment), pseudo-Hirschsprung’s (e.g., internal anal sphincter achalasia), and colorectal motility disorders (e.g., chronic intestinal pseudo-obstruction, slow-transit constipation).

Results:

  • Contrast enema remains the cornerstone for identifying the transition zone and rectosigmoid ratio abnormalities in HD.
  • Ultrasound shows promise in detecting rectal wall thickening and muscularis hypertrophy.
  • MRI and CT aid in complex cases and postoperative evaluation.
  • Nuclear scintigraphy and fluoroscopic motility studies differentiate neuropathic from myopathic dysmotility.
  • Interventional radiology supports image-guided biopsy, decompression, and botulinum toxin injection in selected cases.

Conclusions: Radiological imaging provides critical anatomical and functional insights in the diagnosis and management of HD and related disorders. A multimodal approach enhances diagnostic accuracy, especially in atypical presentations and variant forms. Integration of imaging with manometry and histopathology is essential for definitive diagnosis and surgical planning.

Keywords: Hirschsprung’s Disease; Aganglionosis; Hirschsprung Variants; Pseudo‑Hirschsprung’s Disease; Internal Anal Sphincter Achalasia; Colorectal Motility Disorders; Chronic Intestinal Pseudo‑Obstruction; Slow‑Transit Constipation; Contrast Enema; Transition Zone; Rectosigmoid Ratio; Abdominal Radiography; Ultrasonography; Magnetic Resonance Imaging; Computed Tomography; Nuclear Scintigraphy; Colonic Transit Studies; Fluoroscopic Motility Studies; Anorectal Manometry; Image‑Guided Rectal Biopsy; Pediatric Radiology; Interventional Radiology

Citation

Zaparackaite I, Govani ND, Singh H, Singh SJ, Mehta AR, Midha PK, et al. Radiological Imaging in Hirschsprung’s Disease, Its Variants, and Colorectal Motility Disorders: A Comprehensive Review of Diagnostic Findings and Interventional Applications. WebLog J Radiol. wjr.2026.a3104. https://doi.org/10.5281/zenodo.18500977
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