In Hirschsprung's disease, the aganglionic segment is defined histologically by the absence of ganglion cells in which specific layer(s) of the bowel wall?

• A Both the myenteric (Auerbach's) and submucosal (Meissner's) plexuses ✓
• B Submucosal plexus only
• C Myenteric plexus only
• D Muscularis propria and myenteric plexus

Explanation

Hirschsprung's disease results from failure of neural crest cell migration into the bowel wall, leading to absence of ganglion cells in both the submucosal (Meissner's) and myenteric (Auerbach's) plexuses. Rectal suction biopsy with acetylcholinesterase staining is the definitive diagnostic test, showing hypertrophied nerve trunks and absent ganglion cells in the submucosa. Full-thickness biopsy confirms absence in both plexuses. The diagnosis is established by the absence of ganglion cells in the submucosal plexus on suction biopsy, as this layer is most accessible.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.