J Korean Assoc Pediatr Surg.  2018 Jun;24(1):10-13. 10.13029/jkaps.2018.24.1.10.

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

• Lee JY
• Kim DY
• Kim JR
• Namgoong J
• Kim SC

• KMID: 2415880
• DOI: http://doi.org/10.13029/jkaps.2018.24.1.10

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.

Keyword

Hirschsprung disease; Barium enema

MeSH Terms

Barium*
Chungcheongnam-do
Diagnosis*
Enema*
Hirschsprung Disease*
Humans
Infant, Newborn
Medical Records
Retrospective Studies
Barium

Figure

• 

  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).

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  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).

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