contrao irregular, irregularidade da mucosa, e seguido por aparecimento de To determine the relative accuracy of the various radiologic signs of Hirschsprung disease (HD), we retrospectively reviewed both radiographs obtained after a barium enema and the medical records of 62 children who had surgery to prove or exclude the diagnosis of HD. Sensitivity, specificity, PPV, and NPV were 13.3% (95% CI: 3.84%-30.74%); Martucciello G. Hirschsprung's disease, one of the most difficult diagnoses in Hirschsprung disease should be considered in any newborn who fails to pass meconium within 24-48 hours of birth. The most sensitive finding was transitional zone. kontraksi irreguler, 3). The table on the left lists the differential diagnosis for acute abdomen in the neonate. 1, Pediatric Clinics of North America, Vol. . -, Constipation Guideline Committee of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Evaluation and treatment of constipation in infants and children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. . . Sixty patients were enrolled. Sensitividade, especificidade, VPP e VPN foram 46,7%, 100%, 100% e 65,2%, respectivamente, para contrao irregular detectada no enema baritado. INCIDENCE & ETIOLOGY: 1 in 5000 live births, it is more common in males than females. Diagnosing Hirschsprung's disease: increasing the odds of a positive rectal biopsy result. 2020 Oct 31;20(1):499. doi: 10.1186/s12887-020-02403-3. Hirschsprung disease (HD) or congenital aganglionic megacolon is an intestinal motor disorder with an incidence of 1:5000 live births, ranging from 1:14000 to 1:4000 live births ().It results in delayed meconium defecation, abdominal distension, lack of appetite, vomiting, and entrocolitis ().In several cases, the patients may be asymptomatic until adolescence and puberty years . 2015 Jan;31(1):11-5. doi: 10.1007/s00383-014-3632-5. accuracy study of common tests. 2005;146:787792. In another study, the majority of the patients presented after the Federal government websites often end in .gov or .mil. and transmitted securely. infants. e 17,818,34 meses, respectivamente (p=0,983). Frequency of mucosal irregularity in BE in subjects with and without HD is shown in and children with refractory constipation who failed to respond with medical Skaba R. Historic milestones of Hirschsprung's disease (commemorating the 90th Case produced with permission, courtesy of Dr. Frank Gaillard. An official website of the United States government. Which was similar to Alehossein et al study 7, Pediatric Surgery International, Vol. Os achados mais especficos foram contrao irregular, irregularidade da mucosa, e seguido por aparecimento de mucosa em forma de paraleleppedos. Concluso:: 56, No. detected in barium enema. Robotic Swenson pull-through for Hirschsprung's disease in Garcia R, Arcement C, Hormaza L, Haymon ML, Ward K, Velasco C, Correa H, Congeni JD, Brown R, Tyson P, Udall J, Schmidt-Sommerfeld E. Clin Pediatr (Phila). Enter your email address below and we will send you the reset instructions. . 90% (95% CI: 73.44%-97.77%); 57.14% (95% CI: 18.75%-89.58%); and 50.9% (95% CI: HIRSCHSPRUNG'S DISEASE: Definition: Hirschsprung's disease is a disorder of the gut caused due to congenital absence of ganglion cells in the submucosal and myentric plexus of intestine. The appearance is typical of short segment Hirschsprung disease.Case produced with permission, courtesy of Dr. Frank Gaillard. Bethesda, MD 20894, Web Policies PMC The visualization of a rectosigmoid transition zone was highly predictive of HD, but nonvisualization did not rule out HD. Hebra A, Smith VA, Lesher AP. colon Sixty patients were enrolled. Duration of study was one year starting from 2012 April. Adult midgut malrotation is very rare and its . Yan J, Sun J, Wu R, Tan SS, Chen Y, Peng Y, Chen Y. BMC Pediatr. 2020 Oct 31;20(1):499. doi: 10.1186/s12887-020-02403-3. Confirmou-se em 30 (M=20, F=10) dos J Pediatr Surg. 13 In Alehossein et al. 100, No. This is the surest way to identify Hirschsprung's disease. Sixty patients Bipsia foi adanya gambaran . The most sensitive finding was transitional zone. 6, Journal of Pediatric Gastroenterology and Nutrition, Vol. FOIA . Careers. The normal rectosigmoid index is 1. Minimum and maximum of age respectivamente, para contrao irregular detectada no enema baritado. Foram -, de Lorijn F, Reitsma JB, Voskuijl WP, Aronson DC, Ten Kate FJ, Smets AM. 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. obstruction in about 12% of cases in our country Would you like email updates of new search results? No bowel preparation is needed before contrast enema. Background: Hirschsprung's disease is the most common cause of pediatric intestinal obstruction. Following findings were evaluated in BE of each patient: transitional zone (TZ), delay 2 cm) apart above dentate line. Recto-sigmoid ratio less than 1 is diagnostic for the short segment type. paper, TZ was positive in 94% of children with HD Sensitividade, especificidade, VPP e VPN foram 46,7%, 100%, 100% e 65,2%, respectivamente, para contrao irregular detectada no enema baritado. . Disclaimer, National Library of Medicine This cross sectional study was carried out in Imam Khomeini Hospital. biopsy, anorectal manometry and contrast exam were 100%, 93%, and 97% respectively. 63.09%-93.87%), and 78.12% (95% CI: 60.02%-90.68%) respectively for RI. Falha no mecnio foi encontrada em 21 (70%) casos. AG T. D. C. Hirshsprung's Disease and Related Neuromuscular Disorders of the Intestine. The liquid is a barium contrast that shows up on imaging. 17 76.66%-100%); and 65.22% (95% CI=49.75%-78.94%) respectively for irregular contraction 2019 Dec 10;11(12):e6339. 8600 Rockville Pike (jejunization), cobblestone appearance, and irregular contraction (Figures 1 and 2). A stable affected person can endure pneumatic air or hydrostatic barium enema discount beneath fluoroscopic or ultrasonographic guidance. The value of the 24-h delayed abdominal radiograph of barium enema in the diagnosis of Hirschsprung's disease. Taxman TL, Yulish BS, Rothstein FC. 72.2% of children with HD had delayed meconium passage Frequency of cobblestone appearance is shown in Table Failure to pass meconium was found in 21(70%) cases. . available in many centers even without pediatric surgeon. Application of a plain abdominal radiograph transition zone (PARTZ) in Anal manipulation prior to the barium enema examination did not affect the diagnostic value of that procedure. Correspondence: Shahnam Askarpour E-mail: Received 2016 Mar 1; Accepted 2016 Jun 2. 5, Radiologic Clinics of North America, Vol. Disclaimer, National Library of Medicine A false positive transition zone at the splenic flexure was seen in four neonates who had small left colon syndrome rather than HD. mucosa em forma de paraleleppedos. sharing sensitive information, make sure youre on a federal 31, No. Pratap et al. 7 Methods: This was a retrospective study of all neonates and infants referred for radiological evaluation of Manzoor A, Talat N, Adnan HM, Zia MW, Aziz MA, Ahmed E. Cureus. Arq Bras Cir Dig. 2020 Jan-Jun;17(1-2):15-17. doi: 10.4103/ajps.AJPS_35_17. widest diameter of the sigmoid loop when the colon is fully distended by the contrast 2, Scandinavian Journal of Surgery, Vol. The rectosigmoid ratio is a measurement of the diameter of the rectum divided by that of the sigmoid colon during contrast enema. FIGURE 1. Usefulness of Delayed Films of Contrast Enema for Detecting Hirschsprung's Disease. Full thickness biopsy, as a classic approach 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. . in 5% and 100%, respectively Abstract. The contrast enema for Hirschsprung disease predictors of a sharing sensitive information, make sure youre on a federal findings with the specificity about 100%. Irregularity of mucosa was not found in children without HD in this study and 2019 Feb 7;32(1):e1421. Sensitivity, specificity, PPV, and NPV were Avaliar a sensibilidade, especificidade, valor preditivo positivo e valor Sensitividade, especificidade, VPP e VPN foram 46,7%, 100%, 100% e 65,2%, Barium. Sensibilidade, especificidade, VPP e VPN foram 76,7%, 83,3%, 78,1% e 82,1%, respectivamente para o ndice de retossigmoide. Case Discussion. Inclusion criteria were: neonates with failure to pass meconium, abdominal distention, and refractory constipation who failed to respond with medical treatment. To determine the relative accuracy of barium enema findings of Hirschsprung's disease (HD) and to calculate a level of probability for three signs combined. 10, No. Hirschsprung's disease, Chronic constipation, Barium enema, Arquivos Brasileiros de Cirurgia Digestiva : ABCD. In this study, 90% had TZ in barium enema. 5 Constipation Guideline Committee of the North American Society for HD, 17 were 1 year. Conclusion: Explain how the diagnosis is made and describe prevention measures and the usual treatment. treatment. Although the initial diagnosis is mainly based on clinical history and examination and 42, No. Avaliar a sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo de achados radiolgicos para diagnstico de Hirschsprung em pacientes submetidos ao enema opaco. 10 Biopsy was Rectosigmoid index is obtained by dividing the widest diameter of the rectum by the 2, Pediatric Surgery International, Vol. Radiological imaging of Hirschsprung disease. Use of the recto-sigmoid index to diagnose Hirschsprung's disease. Epub 2017 Feb 2. Askarpour S, Peyvasteh M, Imanipour MH, Javaherizadeh H, Hesam S. Arq Bras Cir Dig. 45% of subjects without HD showed TZ in barium enema The aim of this study was to find out the role of barium enema in diagnosis of HD. 5) Other causes: Megacolon can also result from long-term constipation, electrolyte or fluid imbalance in the body, as a complication of certain surgeries and a rare complication in pregnant women. The site is secure. . To determine the relative accuracy of the various radiologic signs of Hirschsprung disease (HD), we retrospectively reviewed both radiographs obtained after a barium enema and the medical records of 62 children who had surgery to prove or exclude the diagnosis of HD. Diagnosing Hirschsprung's disease: increasing the odds of a positive rectal biopsy result. 9 76.7%, 83.3%, 78.1% and 82.1% respectively for rectosigmoid index .Sensitivity, 6 underwent barium enema. Materials and methods: The records of all patients referred by pediatric surgeons from 1988 through 1992 for . Sensitivity, specificity, PPV, and NPV of Epub 2014 Oct 28. A transition point is seen at the junction between sigmoid and descending colon. Transitional zone, delay in barium evacuation after 24 h, rectosigmoid index (maximum with of the rectum divided by maximum with of the sigmoid; abnormal if <1), and irregularity of mucosa (jejunization) were evaluated in barium enema. Reid JR, Buonomo C, Moreira C, Kozakevich H, Nurko SJ. 36, No. Unable to load your collection due to an error, Unable to load your delegates due to an error. Mean age of the cases with HD and without was 17.9018.29 (range 1-60 months) and Diagnosis of Hirschsprung's disease a prospective, comparative Abx usually not indicated 53. Hirschsprung (i.e., failure to pass meconium, constipation, and abdominal distention); Sensitivity, specificity, PPV, and To evaluate sensitivity, specificity, positive predictive value, and negative Sensitivity, specificity, PPV, and NPV were related that TZ agreed with histopathologic index in 87% of Other tests. . cobblestone appearance were 18.3%, 94.7%, 76.5%, and 36.5 in Alehossein et al study Accessibility We are experimenting with display styles that make it easier to read articles in PMC. Lewis NA, Levitt MA, Zallen GS, Zafar MS, Iacono KL, Rossman JE, Caty MG, Glick PL. Careers. months and 17.818.34 months respectively (p=0.983). especially boys. imaging is ordered, and . Sensitivity, This site needs JavaScript to work properly. 5. Read about the barium enema procedure used as a diagnostic tool to diagnose conditions such as diverticulitis, colon polyps, colonic abscesses, cancer, and Hirschsprung disease. 3 What Is New Abdominal distention and irregular contraction, MeSH avaliadas no enema zona de transio, atraso na evacuao de brio aps 24 h, Chen X, Xiaojuan W, Zhang H, Jiao C, Yu K, Zhu T, Feng J. Pediatr Surg Int. Conclusion: 2003 Mar;38(3):412-6; discussion 412-6. doi: 10.1053/jpsu.2003.50070. . showed that TZ and RI were the most frequent sign in contrast enema which was University teaching hospital in northwestern Tanzania. sensibilidade foram calculados para cada achado. The appearance is typical of short segment Hirschsprung disease. P value <0.05 was considered significant. The visualization of a rectosigmoid transition zone was highly . 17 were =/< 1 years old. Alehossein M, Roohi A, Pourgholami M, Mollaeian M, Salamati P. Diagnostic accuracy of radiologic scoring system for evaluation of 8600 Rockville Pike 2012 Jun;28(6):597-601. doi: 10.1007/s00383-012-3094-6. 2021 Jun 4;9(6):678. doi: 10.3390/healthcare9060678. O'Donovan et al. Mucosal irregularity (jejunization) was found in 7 (23.3%) cases. In the study of Noviello and colleagues of 18 cases aged <1 year, three had spasmus, 5). . Racional:: O achado mais sensvel foi zona de transio. 37, No. . Frequency of irregular contractions (IC) finding among cases with and without HD is Os achados mais especficos foram Generating an ePub file may take a long time, please be patient. The Pediatric Gastroenterology team at Providence uses a child-centered approach to diagnose and treat gastrointestinal symptoms and conditions in children and adolescents. Epub 2015 Dec 18. Learn about GI colon barium enema prep, as well as air contrast barium enemas and double contrast barium enemas. 6, Radiologic Clinics of North America, Vol. Os critrios de incluso foram: recm-nascidos com insuficincia de passagem de mecnio, distenso abdominal, e constipao refratria sem resposta ao tratamento mdico. rectum divided by maximum with of the sigmoid; abnormal if <1), and 70, No. We conclude that the single most reliable radiographic sign of HD is the presence of a rectosigmoid transition zone. 2017 Apr;47(4):372-381. doi: 10.1007/s00247-016-3709-5. Twelve (27.9%) patients had the diagnosis of HD based on rectal biopsies. irregularity of mucosa (jejunization) were evaluated in barium enema. HHS Vulnerability Disclosure, Help 2017 May;33(5):581-586. doi: 10.1007/s00383-017-4064-9. contrast enema were 93%, 83%, and 76% respectively. Hepatology and Nutrition. Sensibilidade, especificidade, VPP e VPN foram de 23,3%, 100%, 100% e 56,6%, respectivamente, para a irregularidade da mucosa. Pediatr Radiol. Falha no mecnio foi encontrada em 21 (70%) casos. BE images were analyzed retrospectively by 2 examiners and the results were compared with the histopathology of rectal biopsies. Sciences for interpretation of barium enema. Patients and methods: Proctor ML, Traubici J, Langer JC, Gibbs DL, Ein SH, Daneman A, Kim PC. Would you like email updates of new search results? If the address matches an existing account you will receive an email with instructions to reset your password. Sensitivity, specificity, PPV, and NPV were 90%, 80%, 81.8% and 88.8% respectively for transitional zone in barium enema. 2 Epidemiology Hirschsprung disease affects approximately 1:5000-8000 live births. High obstructions are defined as proximal to the ileum. Failure to pass meconium was noted in 21 (70%) of children with HD. doi: 10.1590/0102-672020180001e1421. In approximately 20% of cases, the diagnosis of Hirschsprung's disease is made beyond the newborn period. were enrolled. Mabula JB, Kayange NM, Manyama M, Chandika AB, Rambau PF, Chalya PL. referred sensitivity and specificity of cobblestone appearance FOIA Sensibilidade, especificidade, VPP e VPN foram de 23,3%, 100%, 100% e 56,6%, respectivamente, para a irregularidade da mucosa. Proximal and distal ends of biopsy specimens were marked Penelitian ini bertujuan mengetahui prosedur pemeriksaan barium enema dalam menegakkan diagnosis hirschsprung disease pada pediatric. You may switch to Article in classic view. colleagues PPV, NPV, specificity , and sensitivity was calculated for each finding. We also acknowledged Department of 14, No. 17, No. Penelitian tahun 1996 oleh A.N.O'Donovan, et al penegakan diagnosis HD dibuat sistem skoring dari 8 tanda radiologi pada pemeriksaan Barium enema, yaitu: 1). The initial investigation 2020. Sensitivity, specificity, PPV, and NPV were 23.3%, 100%, 100% and 56.6% respectively for mucosal irregularity in barium enema. NPV were 23.33% (95% CI: 9.98%-42.29%); 100% (95% CI: 88.32%-100%);100% (95% CI: Enter your email address below and we will send you your username, If the address matches an existing account you will receive an email with instructions to retrieve your username. Federal government websites often end in .gov or .mil. Bookshelf The denervated segment (rectum and distal sigmoid colon in this case) appears narrowed as a result of spasm. Diagnosis of Hirschsprung's Disease an age-related approach in Following findings were evaluated in BE of each patient: transitional zone (TZ), delay in barium evacuation after 24 h, rectosigmoid index (RI), mucosal irregularity (jejunization), cobblestone appearance, and irregular contraction . Symptomatology, pathophysiology, diagnostic work-up, and treatment of 5, Journal of the Korean Association of Pediatric Surgeons, Vol. See this image and copyright information in PMC. Sensibilidade, especificidade, VPP e VPN foram Diagnostic value of the preoperatively detected radiological transition zone in Hirschsprung's disease. Barium suspension is made with normal saline to avoid fluid absorption by the large surface area of the dilated colon. similar to our study. obstruction. Enema baritado usado para a avaliao dos pacientes com o diagnstico . Bethesda, MD 20894, Web Policies Diagnosis of Hirschsprung's disease a prospective, comparative accuracy study of common tests. 19 . A carefully performed contrast enema is indispensable in both the diagnosis of Hirschsprung disease and in assessing the length of bowel involvement. A idade mdia dos casos com a doena de Hirschsprung e sem foi 17,9018,29 meses e 17,818,34 meses, respectivamente (p=0,983). RI Accessibility Hirschsprung disease and hypoganglionosis in adults: radiologic findings and differentiation. COMPLICATIONS AFTER TRANSABDOMINAL SOAVE'S PROCEDURE IN CHILDREN WITH HIRSCHSPRUNG'S DISEASE. Anorectal manometry, rectal suction biopsy, and barium enema are used in our Predictability of 48-h delayed retention of contrast in barium enema in cases of chronic constipation. It is caused by the failure of the ganglion cells to migrate cephalocaudally Os critrios de incluso foram: recm-nascidos com insuficincia de passagem de mecnio, distenso abdominal, e constipao refratria sem resposta ao tratamento mdico.
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