Barium Enema Revisited in the Workup for the Diagnosis of Hirschsprung's Disease.

Autor: Lourenção PLTA; Department of Surgery., Valerini FG; Department of Surgery., Cataneo AJM; Department of Surgery., Ortolan EVP; Department of Surgery., Silveira GLD; Department of Pathology, Botucatu Medical School, Unesp - São Paulo State University, Botucatu., Piva MFL; Department of Surgery., Cucco LDM; Department of Surgery., Rodrigues MAM; Department of Radiology, Mega Imagem Clinic, Santos, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: Journal of pediatric gastroenterology and nutrition [J Pediatr Gastroenterol Nutr] 2019 Apr; Vol. 68 (4), pp. e62-e66.
DOI: 10.1097/MPG.0000000000002242
Abstrakt: Objective: To analyse the diagnostic capacity of barium enema (BE) in the diagnostic investigation for Hirschsprung's disease (HD) was analyzed for transition zone (TZ) identification and rectosigmoid index (RSI) ≤1.0 determination.
Patients and Methods: BE images were analyzed retrospectively by 2 examiners and the results were compared with the histopathology of rectal biopsies.
Results: TZ identification and RSI ≤1.0 were assessed separately and combined in 43 patients. Twelve (27.9%) patients had the diagnosis of HD based on rectal biopsies. TZ identification presented better diagnostic capacity for the 2 examiners than RSI ≤1.0. However, interexaminer agreement was higher for RSI ≤1.0 than for TZ identification. The combination of TZ identification and RSI ≤1.0 increased the sensitivity (83.3%-92.3%) and the negative predictive value (90.4%-92.3%).
Conclusion: Therefore, the high diagnostic sensitivity of TZ identification combined to RSI ≤1.0 reinforces the usefulness of these BE parameters in the screening for Hirschsprung's disease.
Databáze: MEDLINE
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