Hirschsprung's disease in an adult. Special reference to histochemical determination of the acetylcholinesterase activity

A 24-year-old Japanese woman with Hirschsprung's disease was subjected to the combination of barium enema, anorectal manometry, and a histochemical study of acetylcholinesterase (AChE) activity in rectal suction biopsy. The histochemistry revealed a marked increase of AChE positive nerve fibers. The importance of such a study is stressed in order to diagnose Hirschsprung's disease correctly, even in adults. A Z-shaped anastomosis as a modification of Duhamel's method was carried out. The postoperative course was uneventful and she now has normal bowel evacuation.