A full-term male newborn presents with progressive abdominal distention and bilious vomiting; meconium has not been passed by 48 hours of life. Vital signs show HR 145/min, RR 38/min, and temperature 37.2°C. Physical examination reveals a distended abdomen; rectal examination causes explosive stool release. Abdominal X-ray demonstrates transition zone with proximal bowel dilation. There is no maternal polyhydramnios history. Rectal suction biopsy is most likely to show which of the following?
- A)Transmural granulomatous inflammation
- B)Hypertrophy of the circular muscle layer of the pylorus
- C)Absence of ganglion cells in the submucosal and myenteric plexusesGABARITO
- D)Ectopic pancreatic tissue in an ileal diverticulum
- E)Mucosal pseudopolyps limited to the rectum
Explicação
Hirschsprung disease is caused by failure of neural crest cell migration, producing aganglionosis of the distal colon with functional obstruction. Delayed passage of meconium, abdominal distention, and explosive stool after rectal examination are classic clues... Ver explicação completa e trilha adaptativa →