title: Allergic proctitis and abdominal distention mimicking Hirschsprung's disease in infants.
abstract: OBJECTIVE
  To determine the incidence and clinical aspects of allergic proctitis (AP) in infants with symptoms that mimic Hirschsprung's disease (HD).
  
  
  METHODS
  One hundred and five patients less than 6 months of age, who underwent barium enema, anorectal manometry and rectal suction biopsy due to suspicion of HD, were enrolled. Comparison of the patient characteristics associated with each disease was based on the results of the triple testing. The sensitivity and specificity of the three tests, for the diagnosis of HD, were evaluated.
  
  
  RESULTS
  The mean age of enrolled patients was 2.1+/-0.9 months. Based on the three tests, 39 patients (37.1%) were diagnosed with HD, seven patients (6.7%) with AP, and 53 (50.5%) had normal results. Of the 54 patients with transitional zone and a reversed rectosigmoid index on the barium enema, four (7.4%) were patients with AP. The mean age of the AP patients (3.1+/-1.5 months old) was older than the HD children (1.4+/-0.9 months old). The sensitivity of the three tests for HD was 97.4%, 87.2% and 92.3% and the specificity was: 74.2%, 78.8% and 100%, respectively.
  
  
  CONCLUSIONS
  In the infants with severe abdominal distention, the incidence of AP mimicking HD was relatively high. Therefore, consideration of AP should be part of the differential diagnosis in infants with severe abdominal distention or findings that mimic HD. For differentiation of these disorders, a rectal suction biopsy is very useful.
authors.affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jee Hyun
authors.initials: JH
authors.lastname: Lee
authors.forename: Yon Ho
authors.initials: YH
authors.lastname: Choe
authors.forename: Suk-Koo
authors.initials: SK
authors.lastname: Lee
authors.forename: Jeong Meen
authors.initials: JM
authors.lastname: Seo
authors.forename: Ji Hye
authors.initials: JH
authors.lastname: Kim
authors.forename: Yeon-Lim
authors.initials: YL
authors.lastname: Suh
mesh_terms: D000005:Abdomen / Q000473:pathology; D001466:Barium Sulfate; D001706:Biopsy / Q000379:methods; D003937:Diagnosis, Differential; D004733:Enema; D017615:Enteric Nervous System / Q000473:pathology; D005260:Female; D006627:Hirschsprung Disease / Q000175:diagnosis*; D006801:Humans; D015994:Incidence; D007223:Infant; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008365:Manometry; D016269:Milk Hypersensitivity / Q000150:complications; D011349:Proctitis / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D012007:Rectum / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D001466:Barium Sulfate