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162973 Pathology

A 2-year-old girl with a history of chronic constipation since birth is brought to the emergency room because of nausea and vomiting. Physical examination shows marked abdominal distension. Abdominal radiography reveals distended bowel loops with a paucity of air in the rectum. A rectal biopsy shows an absence of ganglion cells. Which of the following is the most likely diagnosis?

AAcquired megacolon
BAnorectal stenosis
CHirschsprung disease
DImperforate anus
Pathology
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