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Diagnosis of Hirschsprung's disease: a prospective, comparative accuracy study of common tests.
De Lorijn, Fleur; Reitsma, Johannes B; Voskuijl, Wieger P; Aronson, Daniel C; Ten Kate, Fiebo J; Smets, Anne M J B; Taminiau, Jan A J M; Benninga, Marc A.
Afiliação
  • De Lorijn F; Department of Pediatric Gastroenterology and Nutrition, Emma Children's hospital AMC/Academic Medical Center, Amsterdam, The Netherlands. f.deloijn@amc.uva.nl
J Pediatr ; 146(6): 787-92, 2005 Jun.
Article em En | MEDLINE | ID: mdl-15973319
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.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Canal Anal / Reto / Enema / Doença de Hirschsprung Tipo de estudo: Diagnostic_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Child, preschool / Female / Humans / Infant / Male / Newborn Idioma: En Revista: J Pediatr Ano de publicação: 2005 Tipo de documento: Article País de afiliação: Holanda País de publicação: Estados Unidos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Canal Anal / Reto / Enema / Doença de Hirschsprung Tipo de estudo: Diagnostic_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Child, preschool / Female / Humans / Infant / Male / Newborn Idioma: En Revista: J Pediatr Ano de publicação: 2005 Tipo de documento: Article País de afiliação: Holanda País de publicação: Estados Unidos