Barium Enema Pathology Correlation In Hirschsprungs Disease At Tash Menelik Ii Hospital Addis Ababa Ethiopia

Background: Hirschsprung’s disease is a common cause of pediatric intestinalrnobstruction. It’s a developmental disorder characterized by the absence of ganglionrncells in the myenteric and submucosal plexuses of the distal intestine resulting inrnfunctional obstruction. Barium enema is a simple and primary study for thernevaluation of clinically suspected Hirschsprung’s disease. rnAim:To review the diagnostic performance of barium enema examinations for therninvestigation of Hirschsprung’s disease. rnMethods: Institution based prospective cross-sectional study at Tikur AnbessarnSpecialized - & Menelik II Hospitals was done with clinically HD suspected rnpatients who have a barium enema & biopsy during the study period, Septemberrn2020 to August 2021. Convenience sampling technique was used. rnResults: A total of 28 cases were evaluated during the study period all having arnbarium enema & biopsy result, of whom 18 were males & 10 were females. Thernminimum & maximum ages at presentation were 10 days & 10 years respectivelyrnwith the median age being 11 months. Constipation was the most commonlyrnpresent clinical symptom followed by abdominal distension & delayed meconiumrnpassage which was found in 50% of the participants. rnThe overall sensitivity, specificity & accuracy of barium enema was 95%, 71.4 %,rn& 88.8 % respectively. Sensitivity, specificity, PPV, and NPV were 90%, 71.4 %,rn90% and 71.4 % respectively for recto-sigmoid index in barium enema. Sensitivity,rnspecificity, PPV, and NPV were 85 %, 85.7%, 94.4% and 66.7 % respectively forrntransitional zone. Sensitivity, specificity, PPV, and NPV were 75%, 100%, 100%rnand 58.3 % respectively for irregular contraction detected in barium enema.rnSensitivity, specificity, PPV, and NPV were 35%, 100%, 100% and 35 %rnrespectively for mucosal irregularity detected in barium enema. rnConclusion: The accuracy of barium enema for the diagnosis of HSD was 88.8 %rn& hence barium enema can be used as a reliable primary diagnostic modality forrnHSD. Irregular contraction & mucosal irregularity were the most specific findingsrnwhereas inverted recto sigmoid index & transition zone had a comparably higherrnsensitivity.

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