An 8-Month-Old Boy Is Brought to Clinic Due to Abdominal

An 8-month-old boy is brought to clinic due to abdominal distension.  The patient has had excessive straining and irritability with bowel movements since birth.  He had been exclusively breastfed, and his symptoms worsened after transitioning to pureed foods.  Vital signs are normal.  Abdominal examination shows distension with mild tenderness to palpation.  Bowel sounds are present, and there is no hepatosplenomegaly.  Barium enema shows a relatively narrow rectum and rectosigmoid area.  The rest of the colon proximal to this segment is significantly dilated.  Colorectal biopsy of which of the following areas is most likely to reveal the underlying cause of this patient's condition?

A) Mucosa of the dilated segment
B) Mucosa of the narrow segment
C) Muscular layer of the dilated segment
D) Submucosa of the dilated segment
E) Submucosa of the narrow segment

Correct Answer:

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