TY - JOUR
T1 - Diagnosis of Hirschsprung's disease: A prospective, comparative accuracy study of common tests
AU - de Lorijn, Fleur
AU - Reitsma, Johannes B.
AU - Voskuijl, Wieger P.
AU - Aronson, Daniel C.
AU - ten Kate, Fiebo J.
AU - Smets, Anne M. J. B.
AU - Taminiau, Jan A. J. M.
AU - Benninga, Marc A.
PY - 2005
Y1 - 2005
N2 - Objective To compare the diagnostic accuracy of contrast enema (CE), anorectal manometry (ARM), and rectal suction biopsy (RSB) for the detection of Hirschsprung's disease (HD ). Study design Following a prospective protocol, infants suspected of HD underwent all 3 index tests. Children with positive results on 2 or more index tests or who continued to have severe bowel problems underwent a full thickness biopsy as reference standard. Clinical follow-up was the reference standard in all other children. Results Between 2000 and 2003, 111 consecutive patients (67 boys; median age, 5.3 months) in whom HD was suspected were enrolled. HD was found in 28 patients. RSB had the highest sensitivity (93%) and specificity (100%) rates, but values were not significantly different from CE (sensitivity, 76%; specificity, 97%) or from ARM (sensitivity, 83%; specificity, 93%). Inconclusive test results occurred in 8 infants with CE, in 15 infants with ARM because of agitation, and in 2 infants with RSB. Conclusion RSB is the most accurate test for diagnosing HD, and it has the lowest rate of inconclusive test results
AB - Objective To compare the diagnostic accuracy of contrast enema (CE), anorectal manometry (ARM), and rectal suction biopsy (RSB) for the detection of Hirschsprung's disease (HD ). Study design Following a prospective protocol, infants suspected of HD underwent all 3 index tests. Children with positive results on 2 or more index tests or who continued to have severe bowel problems underwent a full thickness biopsy as reference standard. Clinical follow-up was the reference standard in all other children. Results Between 2000 and 2003, 111 consecutive patients (67 boys; median age, 5.3 months) in whom HD was suspected were enrolled. HD was found in 28 patients. RSB had the highest sensitivity (93%) and specificity (100%) rates, but values were not significantly different from CE (sensitivity, 76%; specificity, 97%) or from ARM (sensitivity, 83%; specificity, 93%). Inconclusive test results occurred in 8 infants with CE, in 15 infants with ARM because of agitation, and in 2 infants with RSB. Conclusion RSB is the most accurate test for diagnosing HD, and it has the lowest rate of inconclusive test results
U2 - https://doi.org/10.1016/j.jpeds.2005.01.044
DO - https://doi.org/10.1016/j.jpeds.2005.01.044
M3 - Article
C2 - 15973319
SN - 0022-3476
VL - 146
SP - 787
EP - 792
JO - Journal of pediatrics
JF - Journal of pediatrics
IS - 6
ER -