title: Diagnostic scoring system of Hirschsprung's disease in the neonatal period.
abstract: OBJECTIVE
  Eighty to ninety percent of Hirschsprung's disease (HD) patients present in newborns. However, the diagnosis of HD in the neonatal period remains difficult. Our present study aims to propose a diagnostic scoring system and hope this will increase early diagnosis of HD and avoid unnecessary rectal biopsy.
  
  
  METHODS
  In the first study period, 57 suspected HD patients (0-3 months) completed our predetermined study protocol in which barium enema (BE), rectal manometry (RM) and full-thickness rectal biopsy were performed. Symptoms, signs and investigations were analysed for their correlation with HD diagnosis. A HD diagnostic scoring system was developed according to the statistical results and was assessed in 74 patients in the second study period.
  
  
  RESULTS
  Forty-five patients were diagnosed with HD in the first study period. A HD scoring system was developed in which delayed meconium, tight anus, BE and RM were diagnostic factors. A cut-off point of 3 provided 84% of HD patients score >3, whereas 75% non-HD patients score <or=3 (p < 0.05). In the second study group, patients with score <or=3 were selected for rectal biopsy.
  
  
  CONCLUSIONS
  In the neonatal period, using a HD scoring system may help to select patients for further invasive investigation so that unnecessary biopsy can be avoided.
authors.affiliation: Department of Surgery, Beijing Children's Hospital Affiliated to Capital University of Medical Sciences, Xi Chi District, Beijing, China. guo-weihong@tom.com
authors.forename: Weihong
authors.initials: W
authors.lastname: Guo
authors.forename: Qinming
authors.initials: Q
authors.lastname: Zhang
authors.forename: Yongwei
authors.initials: Y
authors.lastname: Chen
authors.forename: Dawei
authors.initials: D
authors.lastname: Hou
mesh_terms: D042241:Early Diagnosis; D006627:Hirschsprung Disease / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012680:Sensitivity and Specificity