Acetylcholinesterase activity in suction biopsies of the rectum in the diagnosis of Hirschsprung's disease

Abstract

Rectal suction biopsies have been employed in 214 subjects suspected of having Hirschsprung's disease. By applying conventional histology and acetylcholinesterase (AChE) determinations, 66 (31%) cases were diagnosed as Hirschsprung's disease—all of which were surgically confirmed. The problem of unsatisfactory biopsy material was circumvented by exclusively assessing for AChE activity. Despite the normal paucity of ganglion cells within the lowest 3 cm of the rectum, excessive enzyme accumulation characteristic of Hirschsprung's disease paralleled the findings obtained from the classical narrowed aganglionic segment.