Gastro Intestinal System
A male infant presented with distension of abdomen shortly after birth with passing of less meconium. Subsequently a full-thickness biopsy of the rectum was performed. The rectal biopsy is likely to show - (LQ)
|A||Fibrosis of submucosa|
|B||Lack of ganglion cells|
|C||Thickened muscularis propria|
|D||Hyalinisation of the muscular coat|
Lack of ganglion cells
Whenever neonate preset with delayed passage of stool, Hirschsprungs disease should be suspected.
Diagnosis of Hirschsnrunq's disease
a. The diagnosis of Hirschsprung's disease is confirmed by rectal suction biopsies
b. Rectal suction biopsies demonstrate
i. Hypertrophied nerve bundles
ii. Absence of gunglion cells
Other diagnostic procedures in Hirschsprung's disease
a. Anorectal manometry measures the pressure of internal anal sphincter while a balloon is distended in the rectum. The results are interpreted as -
i. Normal individual -- Reflex decline in internal sphincter pressure.
ii. Hirschsprung's disease -- Pressure fails to drop, Paradoxical rise in pressure
b. Radiography (Barium enema)
i. It demonstrates the presence of transition zone between normal dilated proximal colon and a smaller caliber
ii. obstructed distal colon caused by non-relaxation of aganglionic bowel.
iii. Delayed passage of stool (meconium) and abdominal distension suggest low intestinal obstruction.