Background and purpose: Diagnosis of Hirschprung's disease is one of the most important problems of pediatric surgeons and leaving it without treatment has its own complications. Early diagnosis in younger age with special attention to clinical and radiological findings can reduce these complications. The aim of this study was to compare the findings of plain abdominal radiography and contrast enema in neonates with Hirschprung's disease.
Materials and methods: Twenty seven neonates referred to Boo-Ali Sina Hospital, in Sari (2007-2009) for Hirschprung's disease underwent abdominal X-ray and barium enema, and the findings were evaluated followed by rectal biopsy was. In all cases, radiological and barium enema findings were seen by a radiologist, and in each view presence of serration in colon, distention of colon, absence of gas in colon, small intestinal distention, soap bubble and mottling in RLQ of abdomen, delay on barium transit, recto-sigmoid index, absence or present of TZ (Transitional Zone) were assessed. Data were analyzed using SPSS 16 software. Chi-Square test and descriptive statistical methods were used for comparing abdominal X-ray and barium enema effectiveness for differentiating patients with Hirschprung's disease.
Results: The findings in plain abdominal radiography were: colonic distention and TZ (82.59%), absence of gas in rectum (48.15%), small bowel distention (7.41%), soap bubble pattern (3.7%) and mottling in RLQ (3.7%). In contrast the findings of enema of neonates were: distention (70.3%), delayed barium transition (59.2%), transitional zone (55.5%), barium-fecal mixing (22.2%), micro colon (7.4%) and serration (3.7%).
Conclusion: A plain abdominal radiography is reliable and useful in diagnosis of the disease in patients with failed contrast enema.

Keywords: Hirschprung\'s disease, neonate, plain abdominal radiography and contrast enema

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