title: Use of the recto-sigmoid index to diagnose Hirschsprung's disease.
abstract: The recto-sigmoid index on barium enema may aid in the diagnosis of Hirschsprung's disease. However, data on its reliability in different age groups are sparse. The recto-sigmoid index and transitional zone were evaluated blindly in 107 patients with diagnostic rectal suction biopsies. Patients were divided into 3 groups: neonates, infants older than 1 month, and children. The recto-sigmoid index and transitional zone agreed with the histopathologic diagnosis in 79% and 87% of the cases, respectively. Their negative predictive values reached clinical significance in infants and children but not in neonates. Their positive predictive values were not significant in any age group. The recto-sigmoid index identified 4 patients with recto-sigmoid Hirschsprung's disease whose diagnosis was missed by evaluating the transitional zone alone.
authors.affiliation: Department of Pediatrics, Division of Gastroenterology, State University Health Sciences Center, Baton Rouge, Louisiana, USA.
authors.forename: R
authors.initials: R
authors.lastname: Garcia
authors.forename: C
authors.initials: C
authors.lastname: Arcement
authors.forename: L
authors.initials: L
authors.lastname: Hormaza
authors.forename: M L
authors.initials: ML
authors.lastname: Haymon
authors.forename: K
authors.initials: K
authors.lastname: Ward
authors.forename: C
authors.initials: C
authors.lastname: Velasco
authors.forename: H
authors.initials: H
authors.lastname: Correa
authors.forename: J D
authors.initials: JD
authors.lastname: Congeni
authors.forename: R
authors.initials: R
authors.lastname: Brown
authors.forename: P
authors.initials: P
authors.lastname: Tyson
authors.forename: J
authors.initials: J
authors.lastname: Udall
authors.forename: E
authors.initials: E
authors.lastname: Schmidt-Sommerfeld
mesh_terms: D000293:Adolescent; D000328:Adult; D001466:Barium Sulfate; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D012809:Colon, Sigmoid / Q000000981:diagnostic imaging / Q000473:pathology; D016001:Confidence Intervals; D003287:Contrast Media; D003937:Diagnosis, Differential; D004733:Enema; D005260:Female; D006627:Hirschsprung Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D011859:Radiography; D012007:Rectum / Q000000981:diagnostic imaging / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013396:Suction
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate