Abdominal X-ray is the primary modality of choice to diagnose Hirschsprung’s disease. Findings may include decreased bowel caliber in the involved segment and colonic distension.

Abdominal plain X-ray findings associated with Hirschsprung’s disease may include:

• Radiography performed in children with Hirschsprung’s disease yields findings similar to those in other forms of distal small intestine obstruction including variable gaseous distention of the colon and small bowel, often with air-fluid levels.
• The colon is usually difficult to identify accurately; gas is usually absent in the rectum.^{_Radiology_Reference_Article_|_Radiopaedia.org-1|[1]}