A male infant presented with distension of abdomen shortly after birth with the passing of less meconium. Subsequently, a full–thickness biopsy of the rectum was performed. The rectal biopsy is likely to show –

"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 — Hypertrophied nerve bundles The 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, the Paradoxical rise in pressure with rectal distention. Radiography (Barium enema) It demonstrates the presence of the transition zone between the normal dilated proximal colon and a smaller calibre obstructed distal colon caused by non-relaxation of aganglionic bowel. Delayed passage of stool (meconium) and abdominal distension suggests low intestinal obstruction.