PMC6629996_01
Supine plain abdominal film with evidence of free air in the peritoneal cavity.
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Plain abdominal X-ray showed free air ( Fig. 1 ).
Histopathology of the doughnut showing (
a
) the presence of ganglion cells in 70% of the circumference on the antimesenteric side (
long arrows
indicate the myenteric plexus,
short arrows
indicate the submucosal plexus) and (
b
) the absence of ganglion cells in 30% of the circumference on the mesenteric side (
arrowheads
indicate the aganglionic myenteric plexus).
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PMC6629996_01_10-1055-s-0039-1693494-i190450cr-2.jpg
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Fig. 2 ). Findings were discussed with the family, and they wished for normal bowel to be pulled through.
Pictorial representation of the pattern of aganglionosis.
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Intraoperative biopsies at the revision pullthrough showed the absence of ganglion cells in 30% of the circumference along the mesenteric border in the entire transverse colon ( Fig. 3 ).