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Diagnostic difficulty may be encountered in Hirschsprung's disease when discrepancy is noted between the histochemical pattern, the presence or absence of ganglion cells, and clinical features. This is mainly a problem in neonates, and the cause of the discrepancy is probably due to biopsy specimens being taken above a short aganglionic segment. When short segment Hirschsprung's disease is suspected, a low suction biopsy should be taken for the demonstration of acetylcholinesterase activity.
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