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Diagnosing Hirschsprung Disease in Children Younger than 6 Months of Age: Insights in Incidence of Complications of Rectal Suction Biopsy and Other Final Diagnoses

Authors :
Beltman, Lieke
Labib, Hosnieya
Masselink, Marit
Backes, Manouk
Benninga, Marc A
Roelofs, Joris J T H
van der Voorn, J Patrick
van Schuppen, Joost
Oosterlaan, Jaap
van Heurn, L W Ernest
Derikx, Joep P M
Beltman, Lieke
Labib, Hosnieya
Masselink, Marit
Backes, Manouk
Benninga, Marc A
Roelofs, Joris J T H
van der Voorn, J Patrick
van Schuppen, Joost
Oosterlaan, Jaap
van Heurn, L W Ernest
Derikx, Joep P M
Source :
Vrije Universiteit Amsterdam Repository
Publication Year :
2023

Abstract

BACKGROUND: The gold standard for diagnosing Hirschsprung disease (HD) in patients younger than 6 months is pathological examination of rectal suction biopsy (RSB). The aim of this study was to gain insight into the following: (1) complications following RSB, (2) final diagnosis of patients referred for RSB, and (3) factors associated with HD.METHODS: Patients suspected of HD referred for RSB at our center were analyzed retrospectively. Severity of complications of RSB was assessed using Clavien-Dindo (CD) grading. Factors associated with HD were tested using multivariate logistic regression analysis.RESULTS: From 2000 to 2021, 371 patients underwent RSB because of infrequent defecation, at a median age of 44 days. Three patients developed ongoing rectal bleeding (0.8%) graded CD1. Most frequent final diagnoses were: HD (n = 151, 40.7%), functional constipation (n = 113, 31%), idiopathic meconium ileus (n = 11, 3%), and food intolerance (n = 11, 3%). Associated factors for HD were male sex (odds ratio [OR], 3.19; confidence interval [CI], 1.56-6.53), presence of syndrome (OR, 7.18; CI, 1.63-31.69), younger age at time of RSB (OR, 0.98; CI, 0.85-0.98), meconium passage for more than 48 hours (OR, 3.15; CI, 1.51-6.56), distended abdomen (OR, 2.09; CI, 1.07-4.07), bilious vomiting (OR, 6.39; CI, 3.28-12.47), and failure to thrive (OR, 8.46; CI, 2.11-34.02) (model R 2 = 0.566). CONCLUSION: RSB is a safe procedure with few and only minor complications. In the majority of patients referred for RSB under the age of 6 months, HD was found followed by a functional cause for the defecation problems. RSB should be obtained on a low threshold in all patients under the age of 6 months with the suspicion of HD.

Details

Database :
OAIster
Journal :
Vrije Universiteit Amsterdam Repository
Notes :
European Journal of Pediatric Surgery vol.33 (2023) nr.5 p.360-366 [ISSN 0939-7248], English
Publication Type :
Electronic Resource
Accession number :
edsoai.on1429719182
Document Type :
Electronic Resource
Full Text :
https://doi.org/10.1055.s-0043-1760839