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학습 자료 둘러보기 →The most critical early sign is failure to pass meconium within 48 hours of birth. This is the hallmark initial presentation and should immediately raise suspicion.
As the infant develops, the functional obstruction manifests as chronic constipation that is refractory to standard treatments. This is a direct consequence of the aganglionic segment lacking peristalsis.
Do not confuse this with pyloric stenosis, which presents with projectile vomiting, or with infectious colitis, which presents with loose, foul-smelling stools. A digital rectal exam may reveal an empty rectal vault followed by an explosive release of stool and gas, but this is a diagnostic clue, not the most indicative initial finding from history.
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