Factors Associated with False Negative Results of Contrast Enema for Diagnosis of Hirschsprung’s Disease
2
Issued Date
2024-07-01
Resource Type
ISSN
01252208
Scopus ID
2-s2.0-105007305826
Journal Title
Journal of the Medical Association of Thailand
Volume
107
Issue
7
Start Page
514
End Page
522
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of the Medical Association of Thailand Vol.107 No.7 (2024) , 514-522
Suggested Citation
Ruangtrakool R., Kanjanakul W. Factors Associated with False Negative Results of Contrast Enema for Diagnosis of Hirschsprung’s Disease. Journal of the Medical Association of Thailand Vol.107 No.7 (2024) , 514-522. 522. doi:10.35755/jmedassocthai.2024.7.14007 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/110636
Title
Factors Associated with False Negative Results of Contrast Enema for Diagnosis of Hirschsprung’s Disease
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Abstract
Background: The contrast enema diagnosing Hirschsprung’s disease had a high false-negative rate, meaning that even if Hirschsprung’s disease was suspected, the first contrast enema could not diagnose this disease. Objective: To examine factors associated with the false-negative contrast enema. Materials and Methods: Retrospective chart reviews of patients with Hirschsprung’s disease underwent pull-through operations at Siriraj University Hospital between November 2006 and January 2021 were carried out. Results: The sensitivity of the contrast enema was 82.6%. In the 190 patients with contrast enema, 30 out of 172 (17.4%) had false-negative results. To study the associated factors of false-negative contrast enema, the true-positive contrast enema, which was 142, was compared with a false-negative one, which was 30. The median age of the first contrast enema in the true-positive group was 26.6 days and false-negative group was 23.2 days, which was similar (p=0.581). The locations of the transitional zone in any segments of colon had no effect on false-negative contrast enema except for total colonic aganglionosis (TCA). Receiver operating characteristic (ROC) curves and areas under ROC were performed to assess the optimal cut-off value of the interval of rectal examination/rectal wash out withhold prior to contrast enema to predict false-negative. A higher false-negative rate in patients who discontinued the rectal examination of less than two days before the contrast enema than those with two days or more was found (p=0.125). The discontinued interval of rectal irrigation of less than one day before performing the contrast enema affected higher false-negative rates (p=0.091). Conclusion: Age and locations of the transitional zone were not associated with false-negative contrast enema except for TCA. Too short, discontinued intervals of rectal examination, of less than two days and/or rectal irrigation of less than one day before contrast enema were associated with higher false-negative rates.