Constipation is a common abdominal symptom in childhood [, ]. Pediatric surgeons are frequently consulted about children with constipation to search for potentially correctable surgical causes. Suspected Hirschsprung disease is among the common causes of referral. Cases with Hirschsprung disease have a normal anal canal but with defective intestinal motility affecting essentially the rectum and extending to a variable distance along the rest of the intestine []. The perineum appears normal, while the diagnosis depends on typical history, characteristic contrast enema findings, and histopathological evidence of absent ganglion cells in the affected segment. A successful pull-through procedure eliminating the aganglionic segment can offer a permanent cure for constipation in Hirschsprung patients []. Congenital anal stenosis is another correctable surgical cause for constipation; the diagnosis is essentially clinical based on the obvious abnormal shape and location of the anus [].

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