Journal List > J Korean Assoc Pediatr Surg > v.20(2) > 1071942

Kim, Kim, Kim, Namgoong, and Hwang: How Reliable Are Diagnostic Methods of Hirschsprung Disease?



The purpose of this study was to compare the diagnostic accuracy of the non-invasive diagnostic methods and rectal suction biopsy for the detection of Hirschsprung disease (HD).


We reviewed diagnostic methods and results retrospectively in patients who underwent anorectal manometry, barium enema and rectal suction biopsy for the diagnosis of HD at Asan Medical Center from January 2000 to December 2012.


There were 97 patients (59 neonates and 38 infants) in the study period. The overall accuracy of anorectal manometry for the diagnosis of HD was 71.1% and its sensitivity was 51.4% (48.1% in neonate and 62.5% in infant, respectively) and its overall specificity was 82.3% (81.3% in neonate and 83.3% in infant, respectively). The Overall accuracy of barium enema was 66.0% (72.8% in neonate and 55.3% in infant, respectively) and specificity of barium enema was 53.2% (56.3% in neonate and 50.0% in infant, respectively). These results were lower than those of anorectal manometry. The overall sensitivity of barium enema was 88.6% (92.6% in neonate and 75.0% in infant, respectively) and it was higher than the sensitivity of anorectal manometry. Histological studies confirmed HD in 35 patients, in one of whom the suction biopsy showed negative finding.


Accuracy of non-invasive methods for diagnosis of HD in our study is lower than those in previous study, so we need to improve the quality of diagnostic tools in our hospital. We conclude that the rectal suction biopsy is the most accurate test for diagnosing HD, so the biopsy to confirm the diagnosis of the HD is very important.

Figures and Tables

Table 1
Test Results of Barium Enema

Values are presented as patients' number.

HD, Hirschsprung disease.

Table 2
Test Results of Anorectal Manometry

Values are presented as patients' number.

HD, Hirschsprung disease; RAIR, recto-anal inhibitory reflex.

Table 3
Test Results of Suction Biopsy

Values are presented as patients' number.

HD, Hirschsprung disease.

Table 4
Direct Comparison of Accuracy

BE, barium enema; ARM, anorectal manometry; RSB, rectal suction biopsy.


This study was presented at the 30th Annual Congress of Korean Society of Pediatric Surgeons.

No potential conflict of interest relevant to this article was reported.


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