| Diagnosis of Hirschsprung's Disease: an age-related approach in children below or above one year. | |
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MedLine Citation:
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PMID: 19604284 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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AIM: The aim of this study was to evaluate the effectiveness of a differential diagnostic approach to Hirshchsprung's Disease (HD) on the basis of age. METHOD: Data on 185 consecutive children with suspected HD were subjected to an age-related diagnostic approach. The patients were divided into two groups according to age (A < 1 year; B > 1 year). Children in Group A had rectal suction biopsy (RSB) and contrast enema (CE), and in Group B anorectal manometry (ARM) was performed. Patients with a normal recto-anal inhibitory reflex (RAIR) underwent bowel disimpaction and medical treatment. Only selected cases in Group B underwent RSB and CE. RESULTS: In Group A (18 patients) CE showed a colonic transitional zone in three patients, whereas RSB led to the diagnosis of HD in nine. In Group B (167 patients) ARM was not possible in seven patients and it was normal in 140 (normal anal sphincter pressure: 83; hypertonia of the internal anal sphincter: 57). The RAIR was negative in 20 patients. RSB performed in 31 children in Group B confirmed HD in three patients. CONCLUSIONS: For patients with a neonatal onset of constipation RSB is the best diagnostic technique. Chronic constipation is rarely due to HD and ARM is a useful non-invasive screening tool. |
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Authors:
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C Noviello; G Cobellis; M Romano; G Amici; A Martino |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland Volume: 12 ISSN: 1463-1318 ISO Abbreviation: Colorectal Dis Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-12-24 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100883611 Medline TA: Colorectal Dis Country: England |
Other Details:
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Languages: eng Pagination: 1044-8 Citation Subset: IM |
Copyright Information:
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© 2010 The Authors. Colorectal Disease © 2010 The Association of Coloproctology of Great Britain and Ireland. |
Affiliation:
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Pediatric Surgery Unit, Salesi Children Hospital, Ancona, Italy. carmine.noviello@libero.it |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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