A male infant presented with distension of abdomen sholy after bih with passing of less meconium. Subsequently a full-thickness biopsy of the rectum was performed. The rectal biopsy is likely to show ?

Ans. is 'b' i.e., Lack of ganglion cells "Whenever neonate presents with delayed passage of stool, Hirschsprung's disease should be suspected-. Diagnosis of Hirschsprung's disease The diagnosis of Hirschsprung's disease is confirmed by rectal suction biopsies Rectal suction biopsies demonstrate -- i) Hyperophied nerve bundles ii) Absence of ganglion cells Other diagnostic procedures in Hirschsprung's disease Rectal manometry Anorectal manometry measures the pressure of internal anal sphincter while a balloon is distended in the rectum. The results are interpreted as Normal individual --> Reflex decline in internal sphincter pressure. Hirschsprung's disease ---> Pressure fails to drop, Paradoxical rise in pressure with rectal distention. o Radiography (Barium enema) It demonstrates the presence of transition zone between normal dilated proximal colon and a smaller caliber obstructed distal colon caused by non relaxation of aganglionic bowel. Delayed passage of stool (meconium) and abdominal distension suggests low intestinal obstruction.