Diagnosing Hirschsprung's disease: Increasing the odds of a positive rectal biopsy result

2003 ◽  
Vol 38 (3) ◽  
pp. 412-416 ◽  
Author(s):  
Nicola A. Lewis ◽  
Marc A. Levitt ◽  
Garret S. Zallen ◽  
Mona S. Zafar ◽  
Karen L. Iacono ◽  
...  
Keyword(s):  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Rectal Biopsy ◽  
Biopsy Result

Rectal Biopsy for Hirschsprung's Disease – Are We Performing too Many?

2010 ◽  
Vol 20 (02) ◽  
pp. 95-97 ◽  
Author(s):  
N. Rahman ◽  
J. Chouhan ◽  
S. Gould ◽  
Vt. Joseph ◽  
H. Grant ◽  
...  
Keyword(s):  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Rectal Biopsy

scholarly journals Hirschsprung’s Disease: Diagnosis and Management

2021 ◽  
Vol 10 (2) ◽  
pp. 104-113
Author(s):  
Md Benzamin ◽  
Md Rukunuzzaman ◽  
Md Wahiduzzaman Mazumder ◽  
ASM Bazlul Karim
Keyword(s):  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Rectal Biopsy ◽  
Disease Diagnosis ◽  
Radiological Investigation ◽  
Functional Intestinal Obstruction ◽  
The Common ◽  
High Index Of Suspicion ◽  
Hirschprung's Disease ◽  
Related Mortality

Hirschsprung’s disease (HD) is a rare genetic congenital defect of intestine causing failure of migration of parasympathetic ganglionic cells in some definite part of intestine, resulting in functional intestinal obstruction. It commonly involves rectosigmoid region of colon but other parts of colon or total colon, even small intestine may be affected. Incidence is 1/5000 live births. It is one of the common pediatric surgical problems and 2nd most organic cause of constipation. Symptoms may be evident from 1st day of life. About 90% infants with Hirschprung’s disease fail to pass meconium in 1st 24 hours of life. About 80% HD cases are diagnosed in early few months of life and present with abdominal distention, constipation, poor feeding, vomiting etc. HD enterocolitis is a devastating condition related to mortality. HD may be associated with some congenital anomalies and syndrome. High index of suspicion is the main key to diagnosis. Radiological investigation supports the diagnosis and rectal biopsy for histopathology is confirmatory. Although it is a surgical problem, physician can play a key role in early diagnosis and thus help to prevent HD enterocolitis-related mortality and restore near-normal life. J Enam Med Col 2020; 10(2): 104-113

Experience with full-thickness rectal biopsy in the evaluation of patients with suspected Hirschsprung’s disease

2014 ◽  
Vol 10 (2) ◽  
pp. 42-45
Author(s):  
Kayode T. Bamigbola ◽  
Abdulrasheed A. Nasir ◽  
Lukman O. Abdur-Rahman ◽  
Adewale O. Oyinloye ◽  
Nurudeen T. Abdulraheem ◽  
...  
Keyword(s):  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Rectal Biopsy ◽  
Full Thickness

scholarly journals Full-thickness rectal biopsy in children suspicious for Hirschsprung's disease is safe and yields a low number of insufficient biopsies

2018 ◽  
Vol 53 (10) ◽  
pp. 1942-1944 ◽  
Author(s):  
Niels Bjørn ◽  
Lars Rasmussen ◽  
Niels Qvist ◽  
Sönke Detlefsen ◽  
Mark Bremholm Ellebæk
Keyword(s):  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Rectal Biopsy ◽  
Full Thickness

scholarly journals Punch Rectal Biopsy in Diagnosis of Hirschsprung’s Disease - An Updated Study

2020 ◽  
Vol 8 (11) ◽  
pp. 2520-2523
Author(s):  
Abdus Sattar ◽  
Mahfuzul Haque ◽  
Arun Kanti Paul ◽  
Ruhul Quddus
Keyword(s):  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Rectal Biopsy

scholarly journals A Case Report on 2 years Child: Hirschprung’s Disease

2021 ◽  
pp. 558-564
Author(s):  
Anushri Kale ◽  
Aditi Badwaik ◽  
Pallavi Dhulse ◽  
Archana Maurya ◽  
Bibin Kurian
Keyword(s):  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Ganglion Cells ◽  
Past History ◽  
Rectal Biopsy ◽  
Case Presentation ◽  
Surgical History ◽  
History Of ◽  
Pull Through ◽  
Hirschprung's Disease

Introduction: Hirschsprung's disease is the most common cause of large intestinal obstructing in neonates. Hirschsprung's disease is a congenital anomaly caused by migratory failure of neural crest cells leading to abnormal innervations of the bowel .The defect begins in the internal and sphincter and extends proximally for a variable length of gut. Hirschprung's disease is a disorder of the gut caused due to congenital absence of ganglion cells in the sub-mucosal and myenteric plexus of intestine. This disease is also known as megacolon or congenital Aganglionic megacolon. Case presentation: A 2 years old male child, known case of Hirschprung’s disease, was brought to AVBRH for further management. As narrated by the mother, the child was not passing stool since birth. There was no history of abdominal distention, vomiting or fever. The child pass the stool with the help of enema which was given to the child in the morning and evening. Mast. Devansh has past history of NICU stay. In View of not passing stools, USG of abdomen and pelvis done. Endorectal pull through surgery was done on 4/02/2021 under general anesthesia. No any past surgical history. There is a past history of rectal biopsy done in 1 1/2 month of age. Conclusion:The patient was admitted in AVBRH for further management. Then the report mainly focused on surgical management and quality nursing care due to which patient was discharged without any further complication and satisfaction.

Rectal Biopsy as an Aid in the Diagnosis of Hirschsprung's Disease

PEDIATRICS ◽  
1956 ◽  
Vol 18 (2) ◽  
pp. 176-176
Keyword(s):  
Chronic Constipation ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Rectal Wall ◽  
Rectal Biopsy ◽  
Distal Segment ◽  
Large Bowel Obstruction ◽  
Atypical Symptoms ◽  
Typical History ◽  
History Of

The child with a typical history of chronic constipation, and with physical signs of a distended abdomen and an empty rectal ampulla, who is found to have a widely dilated colon with a narrow distal segment by the radiologist, presents no diagnostic problem. However, the diagnosis of Hirschsprung's disease may be very difficult to establish if part of the classical diagnostic criteria are absent or inconclusive. In such cases, the authors have found rectal biopsy to be a useful diagnostic procedure. They cite as indications for biopsy: (1) suspected Hirschsprung's disease in the newborn infant, because the colon does not become dilated and hypertrophied until the intestinal tract has been functioning for several months; (2) symptoms of upper large bowel obstruction developing soon after birth, because barium enema studies of infants whose entire colons are aganglionic reveal no obstruction of the lumen of the large intestine; (3) radiologic evidence of dilatation of the entire distal segment of the colon, because, in patients with a short aganglionic lesion, the obstruction may be so low that the radiologist is unable to demonstrate a narrow segment extending through the rectosigmoid, and (4) atypical symptoms of megacolon, including diarrhea, episodes of intestinal obstruction, or other symptoms of colonic dysfunction. This procedure has been performed by Swenson and his colleagues on 40 patients. Biopsy specimens obtained from 19 patients, subsequently proved to have Hirschsprung's disease by study of the resected rectum and sigmoid, contained no ganglionic cells. In the other 21 patients, biopsy was performed because Hirschsprung's disease was suspected. Ganglionic cells were present in all of these specimens, and the success of subsequent conservative management of these patients confirmed the diagnosis of chronic constipation. Control material was obtained from 10 cadavers with normal colons, and ganglionic cells were found in all of these specimens. The authors emphasize that this technique is only as good as the specimen obtained. An adequate biopsy of rectal wall must be removed. Multiple histologic sections must be carefully examined before the diagnosis of Hirschsprung's disease is confirmed.

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