Is Barium Enema Reliable for the Diagnosis of Total Colonic Aganglionosis?

Ju Yeon Lee; Dae Yeon Kim; Jeong Rye Kim; Jung-Man Namgoong; Seong Chul Kim

doi:10.13029/jkaps.2018.24.1.10

Journal List > J Korean Assoc Pediatr Surg > v.24(1) > 1098224

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Lee, Kim, Kim, Namgoong, and Kim: Is Barium Enema Reliable for the Diagnosis of Total Colonic Aganglionosis?

Original Article

Journal of the Korean Association of Pediatric Surgeons 2018; 24(1): 10-13.

Published online: 30 June 2018

DOI: https://doi.org/10.13029/jkaps.2018.24.1.10

Is Barium Enema Reliable for the Diagnosis of Total Colonic Aganglionosis?

Ju Yeon Lee¹, Dae Yeon Kim²

, Jeong Rye Kim³, Jung-Man Namgoong², Seong Chul Kim²

¹Department of Pediatric Surgery, Chonnam National University Children's Hospital, Chonnam National University School of Medicine, Gwangju, Korea.

²Department of Pediatric Surgery, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.

³Department of Radiology and Research Institute of Radiology, 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, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea. Tel: +82-2-3010-3961, Fax: +82-2-474-6701, kimdy@amc.seoul.kr

Received 9 February 2018 Revised 23 May 2018 Accepted 25 May 2018

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/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Barium enema is one of the diagnostic modalities for Hirschsprung'sdisease. The present study aimed to investigate the diagnostic accuracy of barium enema for Hirschsprung's disease, especially total colonic aganglionosis (TCA).

Methods

We retrospectively reviewed the medical records of all the patients who were diagnosed as having TCA and underwent a barium enema in Asan Medical Center Children's Hospital between January 1998 and December 2016. All the tests were performed and reviewed by pediatric radiologists.

Results

Among the total 19 patients with TCA who underwent barium enema, 9 patients (47.4%) had accurate radiographic results. Eight of the 13 neonate patients (61.5%) showed typical TCA radiological findings. However, only one of the 6 patients aged >4 weeks (16.7%) had accurate radiological diagnosis.

Conclusion

Barium enema showed low accuracy for TCA, and its diagnostic performance was better in neonatal period than in those aged >4 weeks.

Keywords: Hirschsprung disease, Barium enema

Figures and Tables

Fig. 1

Full-term 52-day-old boy with total colonic aganglionosis. False-positive transition zone (arrow) is noted at the descending colon (case 3).

Fig. 2

Total colonic aganglionosis in a 3-day-old boy. Question-mark shape of the colon is noted with cecum and ascending colon. The rectum and descending colon has normal caliber (case 15).

Table 1

Patients summary

ICV, ileocecal valve; M, male; F, female; SB, small bowel; TCA, total colonic aganglionosis; CMC, congenital megacolon.

Notes

^{CONFLICTS OF INTEREST} No potential conflict of interest relevant to this article was reported.

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ORCID iDs: Dae Yeon Kim
https://orcid.org/0000-0001-8852-6389
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