Infantile Hirschsprung's disease ? is a barium enema useful?
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Barium enema
Hirschsprung's disease
Enema
Barium sulfate
Megacolon
• We studied the usefulness of the barium enema to rule out Hirschsprung's disease (congenital megacolon) in the evaluation of infants with constipation. Results from barium enemas in 58 constipated infants and children who underwent rectal suction biopsies to rule out aganglionosis were evaluated in retrospect for the presence of a transition zone, delayed evacuation of barium, and colonic anatomic abnormalities. As expected, the presence of a transition zone was most accurate in predicting Hirschsprung's disease. Eighty percent of infants with aganglionosis had a roentgenographic transition zone, while 20% did not. Twenty-nine percent of infants with a suspected roentgenographic transition zone did not have aganglionosis. Delayed evacuation of barium was a poor predictor of aganglionosis. The presence of delayed evacuation of barium did not improve the accuracy of the transition zone to predict Hirschsprung's disease. Barium enemas did not reveal any additional colonic anatomic defects other than a transition zone to account for constipation in our study group. These results demonstrated that the barium enema is not a specific enough screening procedure to rule out Hirschsprung's disease in the unobstructed infant. Rectal suction biopsy is diagnostic and should be performed as the procedure of choice in those infants suspected of having Hirschsprung's disease. (AJDC1986;140:881-884)
Barium enema
Hirschsprung's disease
Enema
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Neuroradiology
Hirschsprung's disease
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Stimulation of the rectum by stretch results, in the normally innervated bowel, in the reflex relaxation of the internal anal sphincter. The absence of this rectosphincteric reflex in Hirschsprung's disease forms the basis of a simple and safe diagnostic test. Our experience over two years using a simplified air-filled pressure probe system is described, based on the examination of 267 infants and children with abnormal bowel function, of whom 114 were suffering from Hirschsprung's disease.A review of the last 100 consecutive patients examined shows an overall diagnostic reliability of 85%. This was of the same order as that of a barium enema in these patients, and indeed of obtaining the correct diagnosis on the first rectal biopsy. It has proved easier to exclude the disease (90.8%) than to confirm its presence (74.3%), and has been found to be more reliable than the barium enema in the diagnosis of ultrashort segment disease. The commoner pitfalls in the interpretation of the trace are described. We consider that this investigation justifies a place in the routine investigation of Hirschsprung's disease alongside the barium enema and rectal biopsy, and is of particular value as a simple screening test in outpatients.
Barium enema
Hirschsprung's disease
Enema
Barium sulfate
Megacolon
Anal sphincter
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Hirschsprung’s disease is a condition caused by the absence of ganglion cells in the intestine that extend proximally from the anus to a certain distance. The radiological management of Hirschsprung’s case is the examination of barium enema. The main indication in this examination is a change in bowel habits. The purpose of this study was to determine the management of barium enema examination using water soluble contrast media in this hirschsprung case for infant patient aged 5 (five) days in the Radiology Installation of the Regional General Hospital dr. Zainoel Abidin Banda Aceh in 2018. This study was an descriptive study that showed how the process examination of barium enema. The result of this study is that there is a narrowing in the rectosigmoid with abnormal widening in the descending colon area.
Barium enema
Hirschsprung's disease
Enema
Anus
Megacolon
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Descending colon
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The roentgenographic findings in the first month of life were reviewed in a series of 23 infants with histologically proven [See FIG. 9. in source pdf] Hirschsprung's disease. The plain roentgenograms of 18 of the babies showed significant large bowel distention and 12 had prominent colonic fluid levels. In 15 of 19 of the patients which had been subjected to barium enema, the roentgenograms are diagnostic of congenital megacolon. In 5 of 7 of the infants contrast enemas in the first week of life demonstrated the characteristic deformity. The conclusions which appear justified from this investigation are: Congenital megacolon (Hirschsprung's disease) may be strongly suspected in the newborn period in a large majority of cases from the appearance of plain roentgenograms of the abdomen made in recumbent and erect projections. In some instances, roentgenograms in the inverted position supply additional or substantiating evidence of the disease. In lesions starting in the proximal half of the colon, the abdominal distention involves mainly small bowel, and the differentiation from low jejunal or ileal obstruction is usually not possible from the plain roentgenograms. Here examination by barium enema may be expected to establish the diagnosis. When the segment of achalasia begins above the ileocecal valve, the plain roentgenograms again indicate small bowel obstruction, but here barium enema does not demonstrate a significant contour or caliber abnormality of the colon. In this type of case, follow-up roentgenograms 24 and 48 hours after the enema will often show considerable retention of the barium thus suggesting the diagnosis which must be confirmed by biopsy. When the proximal end of the involved segment of colon is low in the rectum, the lesion may be very difficult to demonstrate by barium enema. The age factor alone, i.e., the performance of the examination very early in infancy, does not of itself preclude demonstration of the lesion of Hirschsprung's disease by barium enema.
Barium enema
Megacolon
Hirschsprung's disease
Abnormality
Enema
Ileocecal valve
Barium sulfate
Plain radiography
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Barium enema
Hirschsprung's disease
Enema
Barium sulfate
Megacolon
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Barium enema
Hirschsprung's disease
Enema
Barium sulfate
Megacolon
Anorectal manometry
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Hirschsprung's disease
Barium enema
Megacolon
Enema
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Barium-enema studies and rectal manometry were clearly shown complementary in diagnosing Hirschsprung disease. Of 27 patients studied, 19 had positive barium-enema and rectal manometric studies and were proved histologically to have Hirschsprung disease. Three had positive barium-enemas but normal rectal manometric studies in the first 10 days of life; later manometric studies were positive, and all 3 were subsequently proved to have Hirschsprung disease. Three patients had negative barium-enema and positive manometric studies and were proved to have low segment Hirschsprung disease. If both studies indicate the disease, rectal biopsy is not necessary before surgery.
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Objective To evaluate the value of anorectal manometry, AchE histochemical staining of rectal mucosal biopsy and barium enema in the diagnosis of allied diseases of Hirschsprung's disease. Methods During the period of 1999 2001, 92 patients underwent surgery for Hirschsprung's disease (HD) or allied diseases of Hirschsprung's disease (HAD). Based on the postoperative pathological examinations, the subjects with coexistence of HD and HAD were excluded from this study. Forty cases with HD (36 males and 4 females, a mean age of 21 months) and thirty four cases with HAD (21 males and 13 females, a mean age of 63 months) were selected. The comparisons were made in terms of the findings from their preoperative anorectal manometry, AChE histochemical staining of rectal mucosal biopsy and barium enema between HD and HAD groups. Results There were very significant differences between HD and HAD patients in these three examinations ( P 0.01 ): In HAD group, 85% had recto anal inhibition reflex (RAIR) and a reflex wave with a shape of W or U. 79% of HAD patients were negative in AChE histochemical staining of rectal mucosal biopsy. The barium enema of the most HAD patients showed no obvious narrow and shift segments, but dilatation and barium stagnation over 24 hours had been observed usually in their colon. Conclusions HD and HAD are two kinds of difference diseases. Though they may present a similar constipation, the classic triad of examinations for HD seems to have an important role in their differential diagnosis.
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Hirschsprung's disease
Anorectal manometry
Megacolon
Enema
Barium sulfate
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