This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pediatrics
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 ? 
Select and explain. 
A. Fibrosis of submucosa, B. Lack of ganglion cells, C. Thickened muscularis propria, D. Hyalinisation of the muscular coat
B: Lack of ganglion cells
Answer: B: Lack of ganglion cells 
Explanation: 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.