Document Detail


Diagnosis of Hirschsprung's disease: a prospective, comparative accuracy study of common tests.
MedLine Citation:
PMID:  15973319     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the diagnostic accuracy of contrast enema (CE), anorectal manometry (ARM), and rectal suction biopsy (RSB) for the detection of Hirschsprung's disease (HD). STUDY DESIGN: Following a prospective protocol, infants suspected of HD underwent all 3 index tests. Children with positive results on 2 or more index tests or who continued to have severe bowel problems underwent a full thickness biopsy as reference standard. Clinical follow-up was the reference standard in all other children. RESULTS: Between 2000 and 2003, 111 consecutive patients (67 boys; median age, 5.3 months) in whom HD was suspected were enrolled. HD was found in 28 patients. RSB had the highest sensitivity (93%) and specificity (100%) rates, but values were not significantly different from CE (sensitivity, 76%; specificity, 97%) or from ARM (sensitivity, 83%; specificity, 93%). Inconclusive test results occurred in 8 infants with CE, in 15 infants with ARM because of agitation, and in 2 infants with RSB. CONCLUSION: RSB is the most accurate test for diagnosing HD, and it has the lowest rate of inconclusive test results.
Authors:
Fleur De Lorijn; Johannes B Reitsma; Wieger P Voskuijl; Daniel C Aronson; Fiebo J Ten Kate; Anne M J B Smets; Jan A J M Taminiau; Marc A Benninga
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of pediatrics     Volume:  146     ISSN:  0022-3476     ISO Abbreviation:  J. Pediatr.     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-06-23     Completed Date:  2005-07-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  787-92     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatric Gastroenterology and Nutrition, Emma Children's hospital AMC/Academic Medical Center, Amsterdam, The Netherlands. f.deloijn@amc.uva.nl
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MeSH Terms
Descriptor/Qualifier:
Anal Canal / pathology*
Biopsy / methods
Child
Child, Preschool
Contrast Media
Diatrizoate Meglumine / diagnostic use
Enema*
Female
Follow-Up Studies
Hirschsprung Disease / diagnosis*,  surgery
Humans
Infant
Infant, Newborn
Male
Manometry
Predictive Value of Tests
Prospective Studies
Rectum / pathology*
Sensitivity and Specificity
Suction
Chemical
Reg. No./Substance:
0/Contrast Media; 131-49-7/Diatrizoate Meglumine

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