DOI: https://doi.org/10.36347/sjams.2024.v12i08.026

Pages: 1075-1085

Background: A condition that affects the large intestine (colon) and causes problems with passing stool is called Hirschsprung's (HIRSH-sproongz) disease. The condition is present at birth (congenital) as a result of missing nerve cells in the muscles of the baby's colon. Objectives: The aim of the study was one staged primary transanal endorectal pull through procedure, barium enama X-ray is an important initial diagnostic procedure in the evaluation on the determination of the level of aganglionosis preoperatively for HD in neonates. Methods: This prospective study was carried out in the Department of Paediatric Surgery and the Department of Radiology & Imaging, Dhaka Shishu Hospital (DSH) & Bangladesh Institute of Child Health (BICH) Dhaka during the period of July 2016 to June 2021. The study was conducted on 45 neonates of either sex admitted in Dhaka Shishu Hospital with Astuspected HD with exclution of patients with pneumoperitoneum on plain X-ray, too sick needed emergency laparotomy and patients who had BE X- ray but did not have rectal biopsy report. Results: A total of 37 neonates were enrolled in the study. Male Female ratio was 3.1:1. The mean age was 16.5days. The mean weight was 2.87kg. Punch rectal biopsy was done in 31 (83.8%), laparotomy and biopsy in 7(18.9%) cases. Rectosigmoid index was <1 in 31 (83.7%) cases out of which 30 were HD positive and 1 was HD negative as proved by histopathological study. Retention of barium was present in 19(65.5%) out of which 17 were HD positive, 2 HD negative. For retention of barium of barium alone, sensitivity was 65.38%, specificity 33.33%, accuracy 62.1%, positive predictive value 89.5% and negative predictive value 10%. So, retention of barium alone is not reliable for the diagnosis of HD. Conclusion: Barium enema X-ray could predict the level of aganglionosis in all rectosigmoid HD. It proved that Barium enema x-ray is a sensitive, specific and accurate investigation for the diagnosis of Hirschprung's .....