Imaging Findings on Contrast Enema of Hirschsprung Disease

Abstract

Objective: To describe imaging findings on contrast enema of Hirschsprung disease at King Chulalongkorn Memorial Hospital. Materials and Methods: The present study was a retrospective study, approved by the present institute ethic Committee. The requirement for informed consent was waived. Between January 2002 and March 15, 2021, the imaging, medical, and histopathologic information of 48 cases with histopathologically proven Hirschsprung disease were evaluated. Results: Forty cases out of 48 (83.33%) that met the inclusion criteria were male. Neonate and infant patients made up 42 cases. According to histopathologic data, there were diseases in the short segment in 60.42% of the study cases, the long segment in 12.50%, and the entire colon in 14.58%. The common symptoms were abdominal distention, delayed passing meconium, constipation, and poor feeding. The transitional zone in 40 out of 48 (83.33%) was the most often observed imaging finding. Out of the 48 patients, additional imaging findings for 17 (35.41%) was reverse rectosigmoid ratio, for nine (18.75%) was serration, for three (6.25%) was microcolon, and for one (2.08%) was short colon. The transitional zone was also most common among cases of short and long segment diseases. In the cases of total colonic disease, transitional zone and non-diagnostic imaging were equal. Conclusion: The transitional zone, reverse rectosigmoid ratio, and serration are common imaging findings for Hirschsprung disease on contrast enema at King Chulalongkorn Memorial Hospital. Non-diagnostic findings were uncommon but frequently observed in total colonic aganglionosis with variety of patterns. Therefore, if a diagnosis is clinically suspected, a biopsy may be required to confirm it. Keywords: Contrast enema; Hirschsprung disease