• Advances in pediatric surgery
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• v.20 no.2
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• pp.33-37
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• 2014

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.

• Journal of Yeungnam Medical Science
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• v.14 no.2
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• pp.393-398
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• 1997

An accurate early diagnosis of congenital midgut malrotation is essential to prevention of catastrophic effects of volvulus. To evaluate the usefulness of radiologic examinations in diagnosing intestinal malrotation, we retrospectively analyzed radiologic findings and operation records of 17 intestinal malrotation patients, who were radiologically diagnosed. The age range of the patients studied were from 1day to 12years. The presenting symptoms were vomiting, vomiting with abdominal pain, abdominal distention, diarrhea and failure to thrive. The viewpoints of this analysis were the location of duodeno-jejunal flexure on barium meal and cecal location on barium enema. Sixteen of 17 patients, who were radiologically diagnosed, were surgically proven, but one patient with annular pancreas was false positive. In the case of 3 surgically proved patients, malrotation was suspected on barium meal prior to the barium enema, but final diagnosis was determined on barium enema examination. We concluded that a barium enema should be performed on all children with suspected malrotation where the initial upper gastro-intestinal study was normal or suspicious on account of the small incidence of false positive and false negative barium meals.

• Journal of The Korean Radiological Technologist Association
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• v.28 no.1
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• pp.49-54
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• 2002

Purpose : The objective of the study is to compare and examine the efficacies of barium enema and air reduction as infantile intussusception treatment. Objects and Methods: A retrospective research was conducted on infantile intussusception patients from

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.2 no.2
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• pp.256-261
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• 1999

Ileus caused by impaction of hardened residual barium stagnated in the colon, a rare complication of barium-enema examination, constitutes a particularly serious problem when it occurs in congenital megacolon patients. The administration of gastrografin in such case has proven efficacy in dissolution of impacted barium refratory to routine means of evacuation. We experienced a case of barium-impaction occurred in 6-months old male who had congenital megacolon. Gastrografin enema was a safe and simple method used in the management of this case.

• Korean Journal of Digital Imaging in Medicine
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• v.2 no.1
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• pp.150-157
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• 1996

• Journal of Veterinary Clinics
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• v.25 no.6
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• pp.549-552
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• 2008

An eight-month-old, intact female Jindo, weighing 9 kg with a one-day history of acute bloody diarrhea was referred. Plain abdominal radiographic findings included evidence of a soft tissue tubular mass within the dilated colon. In ultrasonographs, a target-like mass was identified with multiple hyperechoic and hypoechoic parallel wall layers. A barium enema showed a large radiolucent filling defect within the colon and a completely occlusive lumen. On the basis of these images, ileocecocolic and colocolic intussusception was diagnosed. Surgical manual reduction, resection and anastomosis were performed. The patient recovered normally without any complications or recurrence.

• Tuberculosis and Respiratory Diseases
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• v.41 no.1
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• pp.63-67
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• 1994

A 70-year-old female patient was admitted due to the impression of lung abscess via local clinic. Chest P-A showed air shadow containing huge mass lesion in the right lower lung field, pericardio phrenic angle. But the patient complained of only mild upper respiratioy tract infection symptoms and the laboratory tests were within normal limits. Barium enema and chest C-T taken right after barium enema were performed in suggestion of the diaphragmatic hernia. Barium filled transverse colon and associated omentum were in the right anterior hemithorax surrounded by the hernial sac. The mass lesion shown in the chest P-A was compatible with the diaphragmatic hernia, Morgagni type. Operative reduction of the herniated bowel and simple closure of the diaphragm was performed.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1273-1276
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• 2012

Purpose: The incidence of colorectal cancer (CRC) has been increasing in Asian countries including Thailand. Double contrast barium enema (DCBE) is one of the investigation tools used in CRC screening. This study aimed to determine the incidence of colorectal neoplasm detected at screening by DCBE in Thai people. Methods: The computerized radiology database of screening DCBE in Thai adults between June 2009 and October 2011 at the Faculty of Medicine, Siriraj Hospital, was reviewed. DCBE examination performed in a surveillance program after curative CRC resection or the removal of colorectal polyps was also considered as a screening DCBE. Results: A total of 819 screening DCBEs performed during this 28-month period were analyzed. The mean age of patients was $59.8{\pm}13.6$ years. Of the total, 467 (57%) were male. A family history of CRC and a previous history of curative CRC resection or polyp removal were noted in 34 patients (4%) and 124 patients (15%), respectively. A total of 31 patients (3.8%; 95%CI = 2.7%-5.3%) were reported to have colorectal polyp or mass demonstrated on DCBE. Of these, follow-up endoscopy was performed in 20 cases (65%). According to pathological results, the incidence of advanced adenoma and CRC detected at screening DCBE was 0.7% (95%CI = 0.3%-1.6%; n=6) and 0.4% (95%CI = 0.1%-1.1%; n=3), respectively. Conclusions: The screening DCBE performed in Thai adults had a diagnostic yield of 0.7% for advanced adenoma and 0.4% for CRC.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.6 no.1
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• pp.24-31
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• 2003

Purpose: As diagnostic tools for Hirschsprung's disease (HD), barium enema and rectal biopsy have radiation exposure and invasiveness respectively; however anorectal manometry does not have these disadvantages. We therefore performed this study to evaluate the diagnostic efficacy of anorectal manometry. Methods: We reviewed medical records of infants with one or two symptoms of vomiting, abdominal distension, chronic diarrhea or constipation who had a anorectal manometry followed by barium enema and/or biopsy from July 1995 to May 2002. We evaluated the sensitivity, specificity and predictive value of anorectal manometry and barium enema for diagnosis of HD. We also measured sphincter length, median value of balloon volume at which rectoanal inhibitory reflex (RAIR) occurred. Results: All 61 patients received anorectal manometry, 33 of 61 received barium enema. 18 of 61 were diagnosed as HD according to histology and 43 of 61 were evaluated as a control. The sensitivity, specificity, positive predictive value, negative predictive value of anorectal manometry and barium enema for diagnosis of HD were 1.00, 0.91, 0.82, 1.00 and 0.93, 0.67, 0.70, 0.92 respectively. The mean value of sphincter length in control was $1.68{\pm}0.67$ cm and correlated with age, weight and significantly longitudinal length. The median value of balloon volume at which RAIR occurred was 10 mL and did not correlated with age, weight and longitudinal length. Conclusion: This study suggests that anorectal manometry is an excellent initial screening test for Hirschsprung's disease because of its safety and accuracy.

• Advances in pediatric surgery
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• v.7 no.2
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• pp.105-111
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• 2001

To investigate the diagnostic accuracy and applicability of barium enema(BE) and rectal suction biopsy with acetyl cholinesterase(AChE) histochemistry in the diagnosis of neonatal Hirschsprung's disease(HD), we retrospectively reviewed the findings of BE and AChE staining in 96 neonates with suspected HD during a 10-year period from January 1991 to December 2000. Sixty-nine cases of HD(58 males and 11 females) and 27 cases of non-HD are included in this study. In regard to BE, HD was based on definite transitional zone, suspicious HD on reversed rectosigmoid index(RSI <1), and non-HD on normal RSI(RSI>1). The histochemical criterion used for the diagnosis of HD was that of Chow et al(1977), i.e., the presence of many coarse discrete cholinergic nerve fibers in the muscularis mucosae and in the immediately subjacent submucosa regardless of infiltration of cholinergic nerve fibers in the lamina propria. Of 66 neonates with HD who underwent BE, transitional zone was identified in 33 cases(50 %) and reversed RSI in 19 cases(21 %), microcolon in 4 cases and normal finding in 10 cases(15 %) while of 27 neonates with non-HD, there was normal finding in 16 cases and reversed RSI in 9 cases(41 %). Thus diagnostic accuracy based on transitional zone was 64 %. The positive predictive value of reversed RSI for the diagnosis of HD was 68 %. Of 42 neonates with HD who underwent AChE histochemistry, there were 41 AChE-positive reactions and one AChE-negative reaction in a neonate with total colonic aganglionosis, while of 27 cases of non-HD, there were one equivocal AChE-positive reaction and 26 AChE-negative reactions. Thus AChE histochemical study showed a 97 % diagnostic accuracy with a 98 % sensitivity and a 96 % specificity. In conclusion, we believe that BE is valuable as a first diagnostic step since about 80 % of neonates with HD show significant radiologic findings such as a transitional zone or reversed RSI. AChE histochemical study was a more reliable diagnos tic tool showing a 97 % diagnostic accuracy, and is part.