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

Journal of the Korean Association of Pediatric Surgeons 2014; 20(2): 33-37.

Published online: 30 December 2014

DOI: https://doi.org/10.13029/jkaps.2014.20.2.33

How Reliable Are Diagnostic Methods of Hirschsprung Disease?

Hanbaro Kim, Dae Yeon Kim, Seong Chul Kim, Jung-Man Namgoong, Ji-Hee Hwang

Department of Pediatric Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Correspondence: Dae Yeon Kim, Department of Pediatric Surgery, Asan Medical Center Children's Hospital, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea. Tel: +82-2-3010-3961, Fax: +82-2-474-9027, kimdy@amc.seoul.kr

Received 4 August 2014       Revised 1 October 2014       Accepted 1 October 2014

Copyright © 2014 by the Korean Association of Pediatric Surgeons

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

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).

Methods

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.

Results

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.

Conclusion

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.

Keywords: Hirschsprung disease, Anorectal manometry, Barium enema, Rectal suction biopsy, Accuracy

Figures and Tables

Table 1
Test Results of Barium Enema
jkaps-20-33-i001

Values are presented as patients' number.

HD, Hirschsprung disease.

Table 2
Test Results of Anorectal Manometry
jkaps-20-33-i002

Values are presented as patients' number.

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

Table 3
Test Results of Suction Biopsy
jkaps-20-33-i003

Values are presented as patients' number.

HD, Hirschsprung disease.

Table 4
Direct Comparison of Accuracy
jkaps-20-33-i004

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

Notes

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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