ACETYLTHIOCHOLINESTERASE STAINING ACTIVITY OF RECTAL MUCOSA - ITS USE IN THE DIAGNOSIS OF HIRSCHSPRUNGS-DISEASE

  • 1 January 1982
    • journal article
    • research article
    • Vol. 106  (13) , 670-672
Abstract
Increased acetylthiocholinesterase (AchE) reactivity in the rectal lamina propria and lamina muscularis mucosae was used to diagnose Hirschsprung''s disease. A total of 131 specimens were processed with the AchE reaction: 43 suction biopsy specimens and the rest full-thickness specimens. Of the 68 specimens in which neurocytes were present, none demonstrated a diffuse increase in the number of nerve fibers. However, 15 showed focal increases in the numbers of fibers that were not large enough to be regarded as indicative of Hirschsprung''s disease. All patients with a diffuse increase in nerve fibers, regardless of the type of biopsy, had Hirschsprung''s disease. The AchE staining reaction did, however, produce a 29% rate of false-negative reactions (16 of 56 specimens) in patients with Hirschsprung''s disease. An abnormal pattern of AchE reaction is diagnostic of aganglionic megacolon, whereas a normal pattern does not exclude the disease.

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