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Barium Enema in the Diagnosis of Hirschsprung’s Disease: A Comparison with Rectal Biopsy

Mohammad Abbas, Arshad Rashid, Asim Rafiq Laharwal, Ajaz Ahmad Wani, Shabir Ahmad Dar, Manzoor Ahamad Chalkoo, Showkat Majeed Kakroo.

Abstract
Aim: The aim of the present study was to compare the diagnostic accuracy of a barium enema in Hirschsprung’s disease with respect to a rectal biopsy.
Materials And Methods: This study was conducted on 60 consecutive patients of clinically suspected cases of Hirschsprung’s disease admitted to a tertiary care hospital in Kashmir over a period of three and a half years. All the patients were subjected to a barium enema and a full-thickness rectal biopsy.
Results: The mean age was 3.5 + 0.5 years. A rectal biopsy revealed absence of ganglion cells in 36 (60%) patients, absence of ganglion cells with nerve hypertrophy in 4 (6.66%) patients and ruled out Hirschsprung’s disease in 20 (33.33%) patients. A barium enema was compatible with Hirschsprung’s disease in 20 (33.33%), suggestive in 14 (23.33%) and unremarkable in 26 (43.33%) patients. A barium enema had a diagnostic accuracy of 76.67% with a positive predictive value of 88.23%, a negative predictive value of 61.53%, specificity of 80% and a sensitivity of 75%, and a rectal biopsy had a diagnostic accuracy of 100% (P value < 0.0001).
Conclusion: Barium enema is a valuable diagnostic tool for the diagnosis of patients with Hirschsprung’s disease. We recommend a barium enema as a routine initial workup in the management of patients of suspected Hirschsprung’s disease.

Key words: Hirschsprung’s disease, barium enema, rectal biopsy, diagnostic accuracy, constipation


 
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How to Cite this Article
Pubmed Style

Abbas M, Rashid A, Laharwal AR, Wani AA, Dar SA, Chalkoo MA, Kakroo SM. Barium Enema in the Diagnosis of Hirschsprung’s Disease: A Comparison with Rectal Biopsy. Arch Clin Exp Surg. 2013; 2(4): 224-228. doi:10.5455/aces.20120703031135


Web Style

Abbas M, Rashid A, Laharwal AR, Wani AA, Dar SA, Chalkoo MA, Kakroo SM. Barium Enema in the Diagnosis of Hirschsprung’s Disease: A Comparison with Rectal Biopsy. http://www.ejmaces.com/?mno=20782 [Access: September 25, 2018]. doi:10.5455/aces.20120703031135


AMA (American Medical Association) Style

Abbas M, Rashid A, Laharwal AR, Wani AA, Dar SA, Chalkoo MA, Kakroo SM. Barium Enema in the Diagnosis of Hirschsprung’s Disease: A Comparison with Rectal Biopsy. Arch Clin Exp Surg. 2013; 2(4): 224-228. doi:10.5455/aces.20120703031135



Vancouver/ICMJE Style

Abbas M, Rashid A, Laharwal AR, Wani AA, Dar SA, Chalkoo MA, Kakroo SM. Barium Enema in the Diagnosis of Hirschsprung’s Disease: A Comparison with Rectal Biopsy. Arch Clin Exp Surg. (2013), [cited September 25, 2018]; 2(4): 224-228. doi:10.5455/aces.20120703031135



Harvard Style

Abbas, M., Rashid, A., Laharwal, A. R., Wani, A. A., Dar, S. A., Chalkoo, M. A. & Kakroo, S. M. (2013) Barium Enema in the Diagnosis of Hirschsprung’s Disease: A Comparison with Rectal Biopsy. Arch Clin Exp Surg, 2 (4), 224-228. doi:10.5455/aces.20120703031135



Turabian Style

Abbas, Mohammad, Arshad Rashid, Asim Rafiq Laharwal, Ajaz Ahmad Wani, Shabir Ahmad Dar, Manzoor Ahamad Chalkoo, and Showkat Majeed Kakroo. 2013. Barium Enema in the Diagnosis of Hirschsprung’s Disease: A Comparison with Rectal Biopsy. Archives of Clinical and Experimental Surgery (ACES), 2 (4), 224-228. doi:10.5455/aces.20120703031135



Chicago Style

Abbas, Mohammad, Arshad Rashid, Asim Rafiq Laharwal, Ajaz Ahmad Wani, Shabir Ahmad Dar, Manzoor Ahamad Chalkoo, and Showkat Majeed Kakroo. "Barium Enema in the Diagnosis of Hirschsprung’s Disease: A Comparison with Rectal Biopsy." Archives of Clinical and Experimental Surgery (ACES) 2 (2013), 224-228. doi:10.5455/aces.20120703031135



MLA (The Modern Language Association) Style

Abbas, Mohammad, Arshad Rashid, Asim Rafiq Laharwal, Ajaz Ahmad Wani, Shabir Ahmad Dar, Manzoor Ahamad Chalkoo, and Showkat Majeed Kakroo. "Barium Enema in the Diagnosis of Hirschsprung’s Disease: A Comparison with Rectal Biopsy." Archives of Clinical and Experimental Surgery (ACES) 2.4 (2013), 224-228. Print. doi:10.5455/aces.20120703031135



APA (American Psychological Association) Style

Abbas, M., Rashid, A., Laharwal, A. R., Wani, A. A., Dar, S. A., Chalkoo, M. A. & Kakroo, S. M. (2013) Barium Enema in the Diagnosis of Hirschsprung’s Disease: A Comparison with Rectal Biopsy. Archives of Clinical and Experimental Surgery (ACES), 2 (4), 224-228. doi:10.5455/aces.20120703031135





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