Document Detail


The contrast enema for Hirschsprung disease: predictors of a false-positive result.
MedLine Citation:
PMID:  17502185     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To examine predictors of a false-positive (FP) result on contrast enema (CE) for the diagnosis of Hirschsprung disease (HD). METHODS: Retrospective analysis, over a 5-year period (1999-2004), of infants (<6 months of age) with suspected HD undergoing rectal biopsy following abnormalities identified on CE (transition zone [TZ], abnormal rectosigmoid ratio, microcolon, retained contrast, or mucosal irregularity). RESULTS: One hundred twenty-nine patients underwent rectal biopsy following an abnormal CE. The FP rate was 48.5% (66 with HD). Age below 30 days (OR, 3.4; 95% CI, 1.1-10.3), female sex (OR, 3.4; 95% CI, 1.6-7.3), and absence of TZ (OR, 6.3; 95% CI, 2.6-15.3) were independently associated with an increased risk for FP on multiple variable logistic regression. A history of bilious emesis decreased the probability of FP (OR, 0.2; 95% CI, 0.06-0.5). CONCLUSIONS: Transition zone, sex, age, and bilious emesis are important predictors of FP in those with suspected HD and CE abnormalities. With 100% incidence of FP, infants younger than 30 days with neither bilious emesis nor a TZ and female infants younger than 30 days with these features may represent a subpopulation in whom rectal biopsy can be avoided.
Authors:
Ivan R Diamond; Giovanny Casadiego; Jeffrey Traubici; Jacob C Langer; Paul W Wales
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  42     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-05-15     Completed Date:  2007-06-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  792-5     Citation Subset:  IM    
Affiliation:
Division of General Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.
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MeSH Terms
Descriptor/Qualifier:
Biopsy
Chi-Square Distribution
Contrast Media*
Enema*
False Positive Reactions*
Female
Hirschsprung Disease / radiography*
Humans
Infant
Infant, Newborn
Logistic Models
Male
Predictive Value of Tests
Retrospective Studies
Sensitivity and Specificity
Chemical
Reg. No./Substance:
0/Contrast Media

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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