Biopsy in Hirschsprung's disease can be taken from:
Ans: A (4 cm...) "Biopsy should be taken atleast2 cm above the dentate line"- S. Das Textbook of Surgery 5th/1036"A rectal biopsy is the gold standard for the diagnosis of Hirschsprung's disease. In the newborn period, this is done at the bedside with minimal morbidity using a special suction rectal biopsy instrument. It is importantto obtain the sample at least 2 cm above the dentate line to avoid sampling the normal transition from ganglionated bowel to the paucity or absence of ganglia in the region of the internal sphincter. In older children, because the rectal mucosa is thicker, a full-thickness biopsy is obtained under general anesthesia. Absent ganglia, hypertrophied nerve trunks, and robust immunostaining for acetylcholinesterase are the pathologic criteria to make the diagnosis"-Sobiston 18th/2065"Rectal suction biopsies are the procedure of choice & should be performed no closer than 2cm to the dentate line to avoid the normal area of hypoganglionosis at the anal verge"-Nelson 18th/1566"The definitive diagnosis of Hirschsprung's disease is made by rectal biopsy. Samples of mucosa and submucosa are obtained at 1 cm, 2 cm, and 3 cm from the dentate line"-Schwartz 8th"Definitive diagnosis is made by rectal biopsy. Mucosal and submucosal biopsies may be taken from the posterior rectal wall with a suction biopsy capsule without anesthesia at the bedside. Serial sections may demonstrate the characteristic lack of ganglion cells and proliferation of nerve trunks in Meissner's plexus. If the findings are equivocal, it is necessary to remove a 1-cm or 2-cm full-thickness strip of mucosa and muscularis from the posterior rectum proximal to the dentate line under anesthesia "-CSDT 11th/1321Procedures for HSThe definitive method for obtaining tissue for pathologic examination is by a full-thickness rectal biopsy.The specimen must be obtained at least 1.5 cm above the dentate line because aganglionosis may normally be present below this level.
4 cm above the dentate line
4 cm below dentate line
6 cm below dentate line
At the level of dentate line
Colon and Rectum - Benign Colonic Disorders