**Question:** Recurrent obstruction, mass per abdomen and diarrhoea in a child is suggestive of which of the following condition?

A. Hirschsprung disease
B. Meckel's diverticulum
C. Inflammatory bowel disease
D. Neurofibromatosis

**Correct Answer:** **Hirschsprung disease: [Letter A]**

**Core Concept:** Hirschsprung disease is a congenital disorder characterized by the absence of ganglion cells in the rectosigmoid colon and rectum. This leads to impaired transit of fecal matter through the large bowel, causing constipation, abdominal distension, and megacolon.

**Why the Correct Answer is Right:** Hirschsprung disease results in the absence of ganglion cells in the rectosigmoid colon and rectum, causing impaired transit of fecal matter. This results in the clinical triad of constipation, abdominal distension, and megacolon. The disease is usually diagnosed in early childhood.

**Why Each Wrong Option is Incorrect:**

**Option B (Meckel's diverticulum):** This is a congenital accessory lymphoid organ found in the ileum. Although it can cause gastrointestinal bleeding, it is not associated with the clinical triad of Hirschsprung disease.

**Option C (Inflammatory bowel disease):** While inflammatory bowel disease can present with abdominal pain, diarrhoea, and weight loss, the clinical triad of Hirschsprung disease does not include diarrhoea.

**Option D (Neurofibromatosis):** This is a genetic disorder characterized by the development of benign tumors in the nervous system and soft tissues. It does not present with the specific clinical triad of Hirschsprung disease.

**Clinical Pearl:** Hirschsprung disease is a crucial differential diagnosis to consider in cases of recurrent obstruction, mass per abdomen, and diarrhoea in children. Prompt diagnosis and management are essential to prevent complications like megacolon and rectal prolapse.

**Core Concept:** Hirschsprung disease is a congenital disorder characterized by the absence of ganglion cells in the rectosigmoid colon and rectum, leading to impaired fecal transit and the clinical triad of constipation, abdominal distension, and megacolon.