2 research outputs found
Barium enema with reference to rectal biopsy for the diagnosis and exclusion of Hirschsprung disease
Background: Hirschsprung disease is congenital disease caused by a lack
of ganglion cells in the distal bowel wall which results in functional
obstruction of the aganglionic segment due to failure of relaxation
during peristalsis. Barium enema is the best imaging modality to
diagnose Hirschsprung disease but the gold standard to confirm the
diagnosis is biopsy. Methods: A retrospective study to assess barium
enema accuracy relative to rectal biopsy in diagnosing Hirschsprung
disease was done at Tikur Anbessa Specialized Hospital and data were
collected from August 1st to 14th 2010. Seventy one patients who had
undergone both rectal biopsy and barium enema examination between
January 2002 and December 2009 were studied. In this study
patients’ record were reviewed and radiologic findings were
compared with histopathology results. The results were analyzed using
SPSS16. Results: In our study the mean age at diagnosis was 19 months
which is a late diagnosis compared to other studies. Hirschsprung
disease was more common in males and recto sigmoid was the most common
area of transition zone. Large number of patients had emergency
operation and diagnosis was late. Total percent agreement of barium
enema and biopsy to diagnose HD is 79.1% and Kappa agreement of 0.34.
In children greater than 1 year old accuracy of barium enema was very
high (91.1%). Conclusion and recommendation: Sensitivity of barium
enema is less in neonates. If barium enema has positive result
intervention can be done safely, especially in children above 1year
old. Biopsy is not always necessary for diagnosing Hirschsprung
disease