Diagnosis of Hirschsprung's disease: a prospective, comparative accuracy study of common tests.
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.
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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
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Child, preschool
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Female
/
Humans
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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