<prompt> 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 ?Fibrosis of submucosaLack of ganglion cellsThickened muscularis propriaHyalinisation of the muscular coat  <response>: Ans. is b i.e., Lack of ganglion cells Whenever neonate presents with delayed passage of stool, Hirschsprungs disease should be suspected-. Diagnosis of Hirschsprungs disease The diagnosis of Hirschsprungs disease is confirmed by rectal suction biopsies Rectal suction biopsies demonstrate -- i Hyperophied nerve bundles ii Absence of ganglion cells Other diagnostic procedures in Hirschsprungs 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. Hirschsprungs 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. 