Browsing by Author "Kebede, Abenezer"

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    Barium Enema – Pathology correlation in Hirschsprung’s disease at TASH & Menelik II Hospital, Addis Ababa, Ethiopia
    (Addis Abeba University, 2021-10) Kebede, Abenezer; Zewdneh, Daniel (MD, Professor of Radiology); Gorfu, Yocabel (MD, Ass. Professor of Radiology); Sissay, Samuel (MD, Consultant Radiologist)
    Background: Hirschsprung’s disease is a common cause of pediatric intestinal obstruction. It’s a developmental disorder characterized by the absence of ganglion cells in the myenteric and submucosal plexuses of the distal intestine resulting in functional obstruction. Barium enema is a simple and primary study for the evaluation of clinically suspected Hirschsprung’s disease. Aim:To review the diagnostic performance of barium enema examinations for the investigation of Hirschsprung’s disease. Methods: Institution based prospective cross-sectional study at Tikur Anbessa Specialized - & Menelik II Hospitals was done with clinically HD suspected patients who have a barium enema & biopsy during the study period, September 2020 to August 2021. Convenience sampling technique was used. Results: A total of 28 cases were evaluated during the study period all having a barium enema & biopsy result, of whom 18 were males & 10 were females. The minimum & maximum ages at presentation were 10 days & 10 years respectively with the median age being 11 months. Constipation was the most commonly present clinical symptom followed by abdominal distension & delayed meconium passage which was found in 50% of the participants. The overall sensitivity, specificity & accuracy of barium enema was 95%, 71.4 %, & 88.8 % respectively. Sensitivity, specificity, PPV, and NPV were 90%, 71.4 %, 90% and 71.4 % respectively for recto-sigmoid index in barium enema. Sensitivity, specificity, PPV, and NPV were 85 %, 85.7%, 94.4% and 66.7 % respectively for transitional zone. Sensitivity, specificity, PPV, and NPV were 75%, 100%, 100% and 58.3 % respectively for irregular contraction detected in barium enema. Sensitivity, specificity, PPV, and NPV were 35%, 100%, 100% and 35 % respectively for mucosal irregularity detected in barium enema. Conclusion: The accuracy of barium enema for the diagnosis of HSD was 88.8 % & hence barium enema can be used as a reliable primary diagnostic modality for HSD. Irregular contraction & mucosal irregularity were the most specific findings whereas inverted recto sigmoid index & transition zone had a comparably higher sensitivity.