Spanish, Serie radiográfica del tracto gastrointestinal inferior, examen radiológico del colon con bario, enema baritado, enema de bario (concepto no activo). Igor Laufer, MD Enema Examination Technique1 Hans Herlinger, MD. This review article presents the principles for performing a safe, comfortable, and. Todavia, o diagnóstico de intussuscepção pode ser efetuado com radiografia simples, ultra-sonografia, tomografia computadorizada e enema baritado ou com .

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Hirschsprung’s disease is the most common cause of pediatric intestinal obstruction. Contrast enema is used for evaluation of the patients with its diagnosis.


To evaluate sensitivity, specificity, positive predictive value, and negative predictive value of radiologic findings for diagnosis of Hirschsprung in patients underwent barium enema. This baritaddo sectional study was carried out in Imam Khomeini Hospital for one year starting fromApril.

Sixty patients were enrolled. Biopsy was obtained at three locations apart above dentate line. Mean age of the cases with Hirschsprung’s disease and without was The most sensitive finding was transitional zone. The most specific findings were irregular contraction, mucosal irregularity, and followed by cobblestone appearance.

Este estudo baritdo foi realizado em Imam Khomeini Hospital por um ano a partir de abril de Hirschsprung’s disease HD is a common cause of pediatric intestinal obstruction 9. It is caused by the failure of the ganglion cells to migrate cephalocaudally through the neural crest causing absence of ganglion cell in all or some parts of colon 1. Prevalence of disease was varitado about 1: In another study from Nigeria, it is the etiology of intestinal obstruction in children with a frequency about Although the initial diagnosis is mainly based on clinical history and examination and baritaddo by pathological examination 3radiographic contrast evaluation may be useful in diagnosis Anorectal manometry, rectal suction biopsy, and barium enema are used in our country.

Anorectal manometry is not available in many hospitals. Barium enema BE is available baritaro many centers even without pediatric surgeon. So, the aim of this study was to evaluate sensitivity, specificity, positive predictive value, and negative predictive value of radiologic findings for diagnosis of HD in patients underwent barium enema.


This cross sectional study was carried out in Imam Khomeini Hospital. Duration of study was one year starting from April. Children barktado history of anorectal surgery, without follow up were excluded.


Informed consent was signed by all parents before inclusion. All patients underwent barium enema and full thickness rectal biopsy. Barium enema was done under supervision of experienced radiologists who are familiar with pediatric radiology. Following findings were evaluated in BE of each patient: Rectosigmoid index is obtained by dividing the widest diameter of the rectum by the widest diameter of the sigmoid loop when the colon is fully distended by the contrast medium 5 Full thickness biopsy, as a classic approach 4was obtained by an baritqdo pediatric surgeon at three location 2, 5, and 7 cm apart above dentate line.

Proximal and distal ends of biopsy specimens were marked for pathologist. PPV, NPV, specificity and sensitivity was calculated for each finding according to bartiado full thickness biopsy as gold standard.

Chi-square was used for analysis. Mean age of the cases with HD and without was Minimum and maximum of age varitado one and 60 months in both groups.

From all cases, abdominal distention was present in 23 Frequency of cobblestone appearance is shown in Table 5. In this study of 60 cases of HD was confirmed using biopsy in 30 cases. In another study, the majority of the patients presented after the first year of life Of HD cases, In Garcia et al. In another study, The result of the two studies were similar. Mucosal irregularity jejunization was found in 7 Irregularity of mucosa was not found in children without HD in this study and Alehossein et al.

The result of two studies were similar. IC was found in IC was not negative in children with HD in the current and Alehossein and colleagues papers 2. In Alehossein et al.

We used barium study in our hospital. It was due to some economic limitation for our patients. Anorectal manometry was not available due to some limitation.


They showed no significant difference among values 5. Previous studies 818 showed that TZ and RI were the most frequent sign in contrast enema which was similar to our study.


Another eneja research is recommended to evaluate diagnostic accuracy of barium enema in low resource setting. This paper is issued from residency thesis of Dr. We also acknowledged Department of Pathology for interpretation of biopsy specimens. National Center for Biotechnology InformationU.

Arq Bariatdo Cir Dig.

Author information Article notes Copyright and License information Disclaimer. Received Mar 1; Accepted Jun 2. This is an open-access article distributed under the terms of the Creative Commons Attribution License. Hirschsprung’s disease, Chronic constipation, Barium enema. Open in a separate window. Delayed passage of contrast material was seen after 48 h of barium enema: RI was normal; IC was not seen. Statistical analysis Chi-square was used for analysis. Finding Specificity Sensitivity TZ Diagnostic accuracy of radiologic scoring system for evaluation of baritadi hirschsprung disease in children.

Constipation Guideline Committee of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Evaluation and treatment of constipation in infants and children: J Pediatr Gastroenterol Nutr.

Symptomatology, pathophysiology, diagnostic work-up, and treatment of Hirschsprung disease in infancy and childhood. Diagnosis of Hirschsprung’s disease a prospective, comparative accuracy study of common tests. The contrast enema for Hirschsprung disease predictors of a false-positive result. Robotic Swenson pull-through for Hirschsprung’s disease in infants.

Hirschsprung’s disease in the newborn. Hirschsprung’s disease in children a five year experience at a University teaching hospital in northwestern Tanzania. Hirschsprung’s disease, one of the most difficult diagnoses in pediatric surgery a review of the problems from clinical practice to the bench. Eur J Pediatr Surg. Diagnosis of Hirschsprung’s Disease an age-related approach in children below or above one year.

Diagnosis of Hirschsprung’s disease. Pattern and outcome of childhood intestinal obstruction at a tertiary hospital in Nigeria. Ileus and intestinal obstruction–comparison between children and adults. Pochaczevsky R, Leonidas JC. Historic milestones of Hirschsprung’s disease commemorating the 90th anniversary of Professor Harald Hirschsprung’s death J Pediatr Surg. Hirschsprung’s disease a review. How useful is the barium enema in the diagnosis of infantile Hirschsprung’s disease.

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