The operative treatment in Hirschsprung’s disease is only undertaken when child –
**Core Concept**
Hirschsprung's disease is a congenital condition characterized by the absence of ganglion cells in the distal colon, leading to a functional obstruction. The operative treatment involves surgical removal of the affected segment and restoration of normal bowel continuity.
**Why the Correct Answer is Right**
The definitive surgical treatment for Hirschsprung's disease is usually undertaken after a period of conservative management to assess the child's response to medical therapy. This involves the use of rectal disimpaction, bowel preparation, and sometimes, temporary colostomy to manage the obstruction. The surgery aims to remove the aganglionic segment and anastomose the healthy bowel, restoring normal bowel function. The timing of surgery is crucial to avoid complications and ensure optimal outcomes.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect as operative treatment is not delayed indefinitely. Early surgery is often recommended to prevent complications such as enterocolitis, malnutrition, and growth failure.
**Option B:** This option is incorrect as operative treatment is not solely dependent on the child's age. While younger children may present with more severe symptoms, surgery can be undertaken at any age, depending on the clinical condition.
**Option C:** This option is incorrect as operative treatment is not solely dependent on the child's weight. While severely malnourished children may require careful preoperative management, surgery can be undertaken once the child is stable enough to undergo the procedure.
**Clinical Pearl / High-Yield Fact**
In Hirschsprung's disease, the absence of ganglion cells in the distal colon leads to a functional obstruction, which can be managed conservatively initially. However, surgical intervention is often necessary to restore normal bowel function and prevent long-term complications.
**Correct Answer:** B.