Rectal biopsy: is it really necessary in anorectal malformations?

This retrospective study of 67 ARM patients challenges the routine practice of rectal biopsy to exclude Hirschsprung disease, finding that true HD coexistence is extremely rare and histological findings often inconclusive or misleading. Long-term follow-up showed excellent outcomes with bowel management alone, suggesting routine ganglia evaluation may lead to unnecessary misdiagnosis and overtreatment.