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J Pediatr. 2005 Jun;146(6):787-92.

Diagnosis of Hirschsprung's disease: a prospective, comparative accuracy study of common tests.

Author information

1
Department of Pediatric Gastroenterology and Nutrition, Emma Children's hospital AMC/Academic Medical Center, Amsterdam, The Netherlands. f.deloijn@amc.uva.nl

Abstract

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.

PMID:
15973319
DOI:
10.1016/j.jpeds.2005.01.044
[Indexed for MEDLINE]

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