Share
Export Citation
Diagnostic accuracy of contrast enema findings in Hirschsprung disease
Faridh M.Z.
Gazzetta Medica Italiana Archivio Per Le Scienze Mediche
Q4Abstract
BACKGROUND: Hirschsprung disease (HD) is a congenital disorder characterized by the absence of ganglion cells in the colon, leading to functional bowel obstruction. While rectal biopsy remains the gold standard for diagnosis, contrast enema imaging serves as a non-invasive diagnostic tool. The aim of this study was to evaluate the diagnostic accuracy of contrast enema findings, including rectosigmoid ratio, transition zone, mucosal irregularities, and 24-h delayed contrast, in diagnosing HD.METHODS: A retrospective study was conducted on 123 pediatric patients suspected of having HD who underwent contrast enema imaging followed by rectal biopsy between January 2021 and June 2024. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of contrast enema variables were analyzed using SPSS software. Statistical significance was set at P<0.05.RESULTS: Among 123 cases, 81.3% were confirmed with HD via biopsy. The most common HD types were short-segment (48.2%) and ultrashort-segment (38.4%). The rectosigmoid ratio had a sensitivity of 51% and specificity of 87%. The transition zone had a sensitivity of 57% and specificity of 78%. Mucosal irregularity exhibited a sensitivity of 21% and specificity of 82.6%. The 24-h delayed contrast image demonstrated the highest sensitivity (87%) but low specificity (39.1%). No significant difference was observed between barium and iodine contrast media.CONCLUSIONS: Rectosigmoid ratio, transition zone, and mucosal irregularity are highly specific findings in diagnosing HD, whereas 24-h delayed contrast imaging provides high sensitivity but low specificity, making it a useful supplementary diagnostic tool.