Mark, a 3-day-old male neonate, is brought to the hospital by his parents due to concerns that he has not passed meconium since birth. They report that his abdomen has become progressively distended, and he has vomited green, bilious material twice in the last 24 hours. He was born full-term via vaginal delivery with no complications, and his Apgar scores were normal. He has been feeding poorly since birth and appears increasingly irritable. Medical and Family History: No significant medical history in the family.No known genetic conditions, but the parents are first-time caregivers with no history of similar neonatal presentations in their family. Physical Examination: Vitals: Temperature: 98.6°F, HR: 130 bpm, RR: 50 breaths/min, BP: 70/40 mmHg. General Appearance: Irritable neonate with poor feeding and abdominal distension. Abdomen: Markedly distended with visible bowel loops. Tympanic to percussion, with tenderness on palpation.No organomegaly. Rectal Examination: Tight anal sphincter with explosive release of stool and gas upon withdrawal of the finger Diagnostic Workup: 1.Abdominal X-ray: Dilated bowel loops with an abrupt transition zone in the distal sigmoid colon. 2.Contrast Enema: Transition zone between the dilated proximal bowel and the narrowed distal bowel. 3.Rectal biopsy: Absence of ganglion cells in the submucosal and myenteric plexuses. Hypertrophied nerve fibers confirmed on histopathology. Which of the following is a life-threatening complication of this disease?
