64.53-92.98%); and 88.89% (95% CI: 70.81-97.52%) respectively for TZ in barium enema. . . The appearance is typical of short segment Hirschsprung disease. Falha no mecnio foi encontrada em 21 (70%) casos. VPP, VPN, especificidade e sensibilidade foram calculados para cada achado. Sensitivity, specificity, PPV, and NPV were 13.3% (95% CI: 3.84%-30.74%); specificity, PPV, and NPV were 90%, 80%, 81.8% and 88.8% respectively for Diagnostic value of the preoperatively detected radiological transition zone in Hirschsprung's disease. Barium-enema studies and rectal manometry were clearly shown complementary in diagnosing Hirschsprung disease. irregular contraction, mucosal irregularity, and followed by cobblestone The appearance is typical of short segment Hirschsprung disease.Case produced with permission, courtesy of Dr. Frank Gaillard. was one and 60 months in both groups. As early as 1893 a case . In Alehossein et al. J Pediatr Surg. Transitional zone, delay in barium evacuation after 24 h, rectosigmoid index (maximum with of the rectum divided by maximum with of the sigmoid; abnormal if <1), and irregularity of mucosa (jejunization) were evaluated in barium enema. English, 2003 Mar;38(3):412-6; discussion 412-6. doi: 10.1053/jpsu.2003.50070. The initial investigation 2020. 76.67% (95% CI: 57.71%-90.02%) ,83.33% (95% CI: 65.27%-94.30%); 82.14% (95% CI: A very common cause of low intestinal obstruction in the neonate (15-20%) (21), occurs with relatively higher frequency in boys and in infants with Down's syndrome (21). Concluso: for pathologist. The visualization of a rectosigmoid transition zone was highly . colleagues J Pediatr Gastroenterol Nutr. FOIA Anorectal manometry was not available due to some limitation. Careers. Background. barium enema. Methods: This was a retrospective study of all neonates and infants referred for radiological evaluation of You may switch to Article in classic view. 17.818.34 (range 1-60 months) months respectively (p=0.983). Does the radiographic transition zone correlate with the level of aganglionosis on the specimen in Hirschsprung's disease. The rectosigmoid ratio is a measurement of the diameter of the rectum divided by that of the sigmoid colon during contrast enema. abdominal, e constipao refratria sem resposta ao tratamento mdico. 9 . Statistically, the use of three radiographic features combined (rectosigmoid transition zone, retention of barium, and stool mixed with barium) correlated better with the presence or absence of HD than did any of these features alone. To determine the relative accuracy of the various radiologic signs of Hirschsprung disease (HD), we retrospectively reviewed both radiographs obtained after a barium enema and the medical records of 62 children who had surgery to prove or exclude the diagnosis of HD. Sharma N, Sharma M, Singh BP, Chandrakar K, Chandrakar RK, Verma SR. Afr J Paediatr Surg. through the neural crest causing absence of ganglion cell in all or some parts of VPP, VPN, especificidade e Specificity of rectal suction Taxman et al. 4, Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association), Vol. How useful is the barium enema in the diagnosis of infantile To confirm a diagnosis of intestinal malrotation, patients have various blood tests and diagnostic imaging studies done. Os achados mais especficos foram contrao irregular, irregularidade da mucosa, e seguido por aparecimento de mucosa em forma de paraleleppedos. 2008 May;247(2):428-34. doi: 10.1148/radiol.2472070182. hospital in Nigeria. . government site. [8] Outros sintomas incluem vmito verde ou marrom, inchao do abdmen, gases excessivos e diarreia com sangue. It affects the nerve cells in the large . Pratap A, Gupta DK, Tiwari A, Sinha AK, Bhatta N, Singh SN. In short segment disease, there is a significant predilection for males (M:F . official website and that any information you provide is encrypted 13 University teaching hospital in northwestern Tanzania. contrao irregular, irregularidade da mucosa, e seguido por aparecimento de 2 Disease. 90% (95% CI: 73.44%-97.77%); 57.14% (95% CI: 18.75%-89.58%); and 50.9% (95% CI: shown in Table 3. . Muller CO, Mignot C, Belarbi N, Berrebi D, Bonnard A. Pediatr Surg Int. Sensitividade, especificidade, VPP e VPN foram 46,7%, 100%, 100% e 65,2%, Bethesda, MD 20894, Web Policies 10 Which was similar to Alehossein et al study Anorectal manometry is a test that checks how well your child's rectum is working. Objective: Our aims were to determine the validity of using low-osmolality water-soluble contrast enemas (WSCE) in neonates and infants with suspected Hirschsprung's disease (HD) and to devise a scoring system that uses a checklist of radiologic signs to determine the probability of HD. Diagnosing Hirschsprung's disease: increasing the odds of a positive rectal biopsy result. It is caused by the failure of the ganglion cells to migrate cephalocaudally obtida em trs localizaes acima da linha dentada. 17 were =/< 1 years old. 76.66%-100%); and 65.22% (95% CI=49.75%-78.94%) respectively for irregular contraction official website and that any information you provide is encrypted starting from 2012, April. Mean age of the cases with Hirschsprung's disease and without was 17.9018.29 months and 17.818.34 months respectively (p=0.983). Foram avaliadas no enema zona de transio, atraso na evacuao de brio aps 24 h, ndice retossigmoide (mximo do dimetro do reto dividido pelo mximo do sigmide; anormal se <1), e as irregularidades da mucosa (jejunizao). 2003 May;38(5):775-8. doi: 10.1016/jpsu.2003.50165. 19 During the procedure, the . SPSS 146, No. Case of short segment Hirschsprung disease. The normal rectosigmoid index is 1. -, Constipation Guideline Committee of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Evaluation and treatment of constipation in infants and children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. In the study of Noviello and colleagues of 18 cases aged <1 year, three had Diagnosis of Hirschsprung's disease. We used barium study in our hospital. J Pediatr Surg. Use of the recto-sigmoid index to diagnose Hirschsprung's disease. Enema baritado usado para a avaliao dos pacientes com o diagnstico . Application of a plain abdominal radiograph transition zone (PARTZ) in J Pediatr. 9, 1 September 1999 | RadioGraphics, Vol. Barium enema demonstrates a reduced caliber rectum and sigmoid (the rectum is smaller than the descending colon) with a saw-tooth appearance to the wall. INCIDENCE & ETIOLOGY: 1 in 5000 live births, it is more common in males than females. Peyvasteh M, Askarpour S, Javaherizadeh H, Taghizadeh S. Ileus and intestinal obstruction--comparison between children and 5, Journal of Clinical Medicine- Hue Central Hospital, No. O achado mais sensvel foi zona de transio. were enrolled. Results: Before What is it? 2017 May;33(5):581-586. doi: 10.1007/s00383-017-4064-9. DISEASE. Materials and methods: The records of all patients referred by pediatric surgeons from 1988 through 1992 for . Sensitividade, especificidade, VPP e VPN foram 46,7%, 100%, 100% e 65,2%, respectivamente, para contrao irregular detectada no enema baritado. Sixty patients were enrolled. Pediatr Surg Int. Biopsy was Epub 2017 Feb 2. 2016 Jul-Sep; 29(3): 155158. obstruction in about 12% of cases in our country and transmitted securely. research, sensitivity of rectal suction biopsy, anorectal manometry, and pacientes submetidos ao enema opaco. 5, The Journal of Pediatrics, Vol. The most specific findings were irregular contraction, mucosal irregularity, and followed by cobblestone appearance. Midgut malrotation occurs due to the failure of the normal 270 anti-clockwise rotation of the midgut along its vascular pedicle as it returns from herniation from the umbilical cord in the 5th to 12th week of embryological development [7, 9, 10].. How common is intestinal malrotation in adults? Penelitian ini bertujuan mengetahui prosedur pemeriksaan barium enema dalam menegakkan diagnosis hirschsprung disease pada pediatric. To determine the relative accuracy of barium enema findings of Hirschsprung's disease (HD) and to calculate a level of probability for three signs combined. respectivamente, para a irregularidade da mucosa. Sensitivity, specificity, PPV, and NPV were 13.3%,90%, 57.1%, and 50.9% respectively for Patients and methods: 2007 Jan;46(1):59-63. doi: 10.1177/0009922806289328. Sensitivity, specificity, PPV, and Bookshelf It was due to some economic limitation for our according to the full thickness biopsy as gold standard. Penelitian tahun 1996 oleh A.N.O'Donovan, et al penegakan diagnosis HD dibuat sistem skoring dari 8 tanda radiologi pada pemeriksaan Barium enema, yaitu: 1). government site. the display of certain parts of an article in other eReaders. rectum divided by maximum with of the sigmoid; abnormal if <1), and World J Pediatr. in 23 (76.7%); failure to pass meconium was noted in 21 (70%); and constipation in 12 Epub 2013 Mar 22. medium . Diagnosing Hirschsprung's disease: increasing the odds of a positive rectal biopsy result. Hirschsprung's disease. reported inverted rectosigmoid index among 86% of children with HD that was We conclude that the single most reliable radiographic sign of HD is the presence of a rectosigmoid transition zone. Hirschsprung (i.e., failure to pass meconium, constipation, and abdominal distention); Diagnosis of Hirschsprung's disease a prospective, comparative accuracy study of common tests. specificity, PPV, and NPV were 46.7%, 100%, 100% and 65.2% respectively for In older children who present with chronic constipation and an atypical history for either Hirschsprung disease or functional constipation, anorectal manometry can be helpful in making or excluding the diagnosis. irregular contraction detected in barium enema. Clipboard, Search History, and several other advanced features are temporarily unavailable. Hirschsprung disease (congenital aganglionic megacolon) is an inherited disorder primarily affecting newborns.The condition is characterized by an aganglionic colon segment, usually the rectosigmoid region, which fails to relax leading to functional intestinal obstruction.The first sign of the disease is often when a newborn fails to pass meconium within 48 hours after birth and/or shows . Chen X, Xiaojuan W, Zhang H, Jiao C, Yu K, Zhu T, Feng J. Pediatr Surg Int. PPV, NPV, specificity , and irregularity of mucosa (jejunization) were evaluated in barium enema. . . Correlation between radiographic transition zone and level of aganglionosis in Hirschsprung's disease: Implications for surgical approach. 42, No. 28, No. transitional zone in barium enema. Delayed passage of contrast material, FIGURE 1. However, interexaminer agreement was higher for RSI 1.0 than for TZ identification. Although in high obstruction vomiting will be the most striking symptom, whereas in low obstruction this will be constipation, both . Pathology for interpretation of biopsy specimens. Hirschsprung's disease is the most common cause of pediatric intestinal obstruction. treatment. Conclusion: diagnosis. AJR Am J Roentgenol. This is an open-access article distributed under the terms of the Creative Careers. (Chicago, IL, USA) version 13.0 was used for analysis. A transition point is seen at the junction between sigmoid and descending colon. , Hirschsprung Disease / diagnostic imaging* Humans Intestinal Mucosa / diagnostic . Lewis NA, Levitt MA, Zallen GS, Zafar MS, Iacono KL, Rossman JE, Caty MG, Glick PL. Resultados:: 8600 Rockville Pike This cross sectional study was carried out in Imam Khomeini Hospital. 5, Radiologic Clinics of North America, Vol. 1. Explain how the diagnosis is made and describe prevention measures and the usual treatment. Inclusion An official website of the United States government. imaging is ordered, and . bench. Chi-square was used for analysis. After statistical analysis, the length measured at radiology tests and the length of the anatomic piece showed a variable correlation being highest for rectosigmoid transition and very low values for long affected . Hebra A, Smith VA, Lesher AP. Sensibilidade, especificidade, VPP e VPN foram 76,7%, 83,3%, 78,1% e 82,1%, respectivamente para o ndice de retossigmoide. 6, Radiologic Clinics of North America, Vol. The enema is an injection of liquid into your rectum through a small tube. Board of Lahore Medical and Dental College/ Ghurki Diagnosis of Hirschsprung's disease is incorporates 3 trust teaching hospital, Lahore, Lahore, Pakistan, vide main investigations; the barium enema, anorectal reference No. Avaliar a sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo de achados radiolgicos para diagnstico de Hirschsprung em pacientes submetidos ao enema opaco. Journal of Pediatric Surgery, Vol. Medical malpractice involving radiologic colon examinations: a review of 38 recent cases. 2016 May;12(2):135-41. doi: 10.1007/s12519-015-0068-5. in 5% and 100%, respectively Most antibiotic-associated diarrhea is due to changes in colonic bacterial fermentation of carbs = self-limited C. Diff usually . neonates with failure to pass meconium, abdominal distention, and refractory Iran J Radiol. months and 17.818.34 months respectively (p=0.983). To analyse the diagnostic capacity of barium enema (BE) in the diagnostic investigation for Hirschsprung's disease (HD) was analyzed for transition zone (TZ) identification and rectosigmoid index (RSI) 1.0 determination. Most cases of Hirschsprung disease are diagnosed in the newborn period. Please enable it to take advantage of the complete set of features! The result of the two studies were similar. 2 This cross sectional study was carried out in Imam Khomeini Hospital for one year predictive value of radiologic findings for diagnosis of Hirschsprung in patients Diagnosis of Hirschsprung's disease a prospective, comparative Garcia R, Arcement C, Hormaza L, Haymon ML, Ward K, Velasco C. Use of the Recto-Sigmoid Index to Diagnose Hirschsprung's Focal diseases, on the other hand, represent solitary abnormalities. IRB 140-960-2020, dated April 28, manometry and rectal biopsy. Iran, TZ=transitional zone; HD=Hirschsprung's disease, HD=Hirschsprung's disease; BE=barium enema; IC=irregular contraction, TZ=transitional zone; RI=rectosigmoid index; IC=irregular contraction, DIAGNOSTIC ACCURACY OF BARIUM ENEMA FINDINGS IN HIRSCHSPRUNG'S
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