This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Stomach and Intestines, Subject name: Pediatrics
Hirschsprung disease, marker - used for early diagnosis - 
Select and explain. 
A. Acetyl cholinesterase, B. Adrenaline, C. VIP, D. None of above
A: Acetyl cholinesterase
Answer: A: Acetyl cholinesterase 
Explanation: Ans. is 'a' i.e., Acetyl cholinesterase Hirschsprung disease (congenital megacoion)o Abnormal innervation of bowel.o Most common cause lowrer intestinal obstruction in neonate.o Absense of ganglion cells in bowel wall.o Absence of meissner and auerbach plexus and hypertrophied nerve bundle with high level of acetyl cholinesterase between muscle layer and submucosa,o Rectum and sigmoid colon involve in 80% of case.o Technique demonstrating ACHE staining in aganglionic instestine are also of interest in diagnosis.