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The Medical Journal of Malaysia May 2020Hirschsprung's Disease (HD) also called congenital aganglionic megacolon is a disorder caused by undeveloped distal to proximal intestinal nerve ganglion cells.... (Comparative Study)
Comparative Study
INTRODUCTION
Hirschsprung's Disease (HD) also called congenital aganglionic megacolon is a disorder caused by undeveloped distal to proximal intestinal nerve ganglion cells. Diagnosis includes determining the aganglionic segment through barium enema radiology examination and histopathology of frozen section with permanent section as gold standard. Determining the diagnostic value of this modality is important for operative management decision.
MATERIALS AND METHODS
The study was a retrospective, cross-sectional study with diagnostic test design. Patient data were obtained in the form of clinical symptoms, barium enema, and frozen section expertise were assessed for the suitability of the diagnostic value by referring to the permanent section as the gold standard.
RESULT
Thirty-four patient data were obtained. The sensitivity, specificity, and accuracy of barium enemas were 95%, 69.2%, and 82%, respectively. The values of sensitivity, specificity, and accuracy of frozen section were 95%, 92.8%, and 88%, respectively. The Cohen-Kappa statistic value was 0.62 (good agreement).
CONCLUSION
Accuracy of FS is better than barium enema in diagnosing HD. In health care center with limitation of histopathological facility, BE could be used as the alternative procedure as interrater comparisons showed good agreement. Therefore, either frozen section or barium enema can be carried out in common or in separate term.
Topics: Barium Enema; Cross-Sectional Studies; Female; Frozen Sections; Hirschsprung Disease; Humans; Indonesia; Infant; Male; Tertiary Care Centers
PubMed: 32471967
DOI: No ID Found -
JAMA Aug 1974
Topics: Barium Sulfate; Enema; Humans; Male; Middle Aged; Sepsis
PubMed: 4408246
DOI: 10.1001/jama.229.6.639c -
Journal Belge de Radiologie 1971
Topics: Barium Sulfate; Colonic Diseases; Enema; Humans; Methods; Radiography
PubMed: 5573427
DOI: No ID Found -
Surgery Today May 2022We investigated whether or not computed tomographic colonography (CTC) is a viable alternative to double-contrast barium enema (BE) for a preoperative rectal cancer...
PURPOSE
We investigated whether or not computed tomographic colonography (CTC) is a viable alternative to double-contrast barium enema (BE) for a preoperative rectal cancer evaluation.
METHODS
The size and distance from the anal canal to the lower or upper tumor borders were laterally measured in 147 patients who underwent CTC and BE. Measurements were grouped into early cancer, advanced, and after chemoradiation therapy (CRT).
RESULTS
In the early and advanced cancer groups, all lesions were visualized by BE. In contrast, 3 (7.8%) early and 8 (7.3%) advanced cases, located at the anterior wall near the anal canal, were not visualized by CTC because of liquid level formation. In the CRT group, 16 (23.5%) and 4 (5.8%) cases were not visualized by CTC and BE, respectively. The BE and CTC size measurements were similar among cohorts. However, the distance from the anal canal's superior margin tended to be longer with BE, especially in early cancer. The differences in distance from the anal canal were significantly larger in the early cancer group than in the other two groups (p = 0.0024).
CONCLUSION
CTC may be a viable alternative imaging modality in some cases. However, BE should be employed in anterior wall cases near the anal canal and CRT cases.
Topics: Barium Enema; Barium Sulfate; Colonography, Computed Tomographic; Colorectal Neoplasms; Contrast Media; Enema; Humans; Rectal Neoplasms; Sensitivity and Specificity
PubMed: 34816321
DOI: 10.1007/s00595-021-02411-5 -
Journal of the Korean Surgical Society Aug 2012The use of barium enemas to confirm the anastomotic integrity prior to ileostomy closure is still controversial. The purpose of the study was to determine the utility of...
PURPOSE
The use of barium enemas to confirm the anastomotic integrity prior to ileostomy closure is still controversial. The purpose of the study was to determine the utility of routine contrast enema prior to ileostomy closure and its impact on patient management in patients with a low pelvic anastomosis.
METHODS
One hundred forty-five patients had a temporary loop ileostomy constructed to protect a low colorectal or coloanal anastomosis following low anterior resection for rectal cancer. All patients were evaluated by physical examination, proctoscopy, and barium enema prior to ileostomy closure.
RESULTS
The median time from ileostomy creation to closure was 8 months. Five (3.5%) of the 144 patients were found to have clinically relevant strictures at the colorectal anastomosis on routine barium enema. One patient (0.7%) showed anastomotic leak on their barium enema. Overall, 141 patients (97.9%) had an uncomplicated postoperative course. Postoperative complication occurred in three patients (2.1%). None of them showed abnormal barium enema finding, which suggested that routine contrast enema examination did not predict postoperative complication.
CONCLUSION
Routine barium enema evaluation of low pelvic anastomoses before loop ileostomy closure did not provide any additional information for postoperative colorectal anastomotic complication.
PubMed: 22880182
DOI: 10.4174/jkss.2012.83.2.88 -
AJR. American Journal of Roentgenology Oct 1982The appropriate interval between a colorectal biopsy and a barium enema is controversial. Superficial and deep biopsies, above and below the peritoneal reflection, were...
The appropriate interval between a colorectal biopsy and a barium enema is controversial. Superficial and deep biopsies, above and below the peritoneal reflection, were performed on 12 dogs. Six control dogs did not have a barium enema. Six study dogs had a barium enema at different postbiopsy time intervals: immediately, 3 days, and 6 days. After superficial biopsies, there was no barium extravasation in any study animal. Histological examination, 48 hr after enema, showed complete epithelialization of all superficial sites on both study and control dogs. When the barium enema was done after a deep biopsy, there was intramural extravasation of barium immediately after biopsy but not after 3 or 6 days. Focal ulcerations were seen microscopically at sites of deep biopsies when the barium enema was performed immediately and 3 days after the diagnostic procedure. All deep biopsy sites were reepithelialized in 6 days. There was no evidence of intraperitoneal or retroperitoneal perforation and no difference in healing of biopsy sites in subjects and control animals. This study in dogs suggests that a barium enema may be performed without hazard immediately after a superficial biopsy of nondiseased colon and 6 days after a deep biopsy.
Topics: Animals; Barium Sulfate; Biopsy; Colon; Dogs; Enema; Extravasation of Diagnostic and Therapeutic Materials; Radiography; Rectum; Time Factors
PubMed: 6981930
DOI: 10.2214/ajr.139.4.693 -
Diseases of the Colon and Rectum Jun 2014Preoperative chemoradiotherapy has been widely used for the prevention of local recurrence of locally advanced rectal cancer, and the effect of chemoradiotherapy is... (Comparative Study)
Comparative Study
BACKGROUND
Preoperative chemoradiotherapy has been widely used for the prevention of local recurrence of locally advanced rectal cancer, and the effect of chemoradiotherapy is known to be associated with overall survival.
OBJECTIVE
We aimed to evaluate the association of the pathologic response grade with tumor recurrence rate after chemoradiotherapy, using radiographic analysis and the Response Evaluation Criteria in Solid Tumors as the parameters.
DESIGN
This study was conducted at a single tertiary care institution in Japan.
SETTING
This was a retrospective cohort study of patients undergoing preoperative chemoradiotherapy.
PATIENTS
A total of 101 low rectal cancer patients receiving preoperative chemoradiotherapy from July 2004 to August 2012 were enrolled.
MAIN OUTCOME MEASURES
The tumor reduction rate was measured with the use of traditional Response Evaluation Criteria in Solid Tumors, barium enema, and CT volumetry, and the correlation between the reduction rate and the pathologic response grade was examined.
RESULTS
The tumor reduction rate assessed according to Response Evaluation Criteria in Solid Tumors showed no association with the pathologic response grade (p =0.61). In contrast, the radiographic response rate by both barium enema and CT volumetry strongly correlated with the pathologic response grade (p < 0.0001 and p = 0.001).In terms of local tumor recurrence, those diagnosed as high responders by the pathologic response grade, Response Evaluation Criteria in Solid Tumors, barium enema, and CT volumetry had a lower recurrence rate (p =0.03, p =0.03, p =0.0002, and p =0.001). The difference between high responders and low responders was especially prominent by barium enema and CT volumetry.
LIMITATIONS
The study is limited by its retrospective nature.
CONCLUSIONS
Double-contrast barium enema and CT volumetry were superior to Response Evaluation Criteria in Solid Tumors in evaluating the effect of chemoradiotherapy and predicting the likelihood of tumor recurrence.
Topics: Adult; Aged; Aged, 80 and over; Area Under Curve; Barium Sulfate; Chemoradiotherapy; Cone-Beam Computed Tomography; Contrast Media; Disease-Free Survival; Enema; Female; Humans; Male; Middle Aged; Neoadjuvant Therapy; Predictive Value of Tests; Preoperative Period; ROC Curve; Rectal Neoplasms; Treatment Outcome; Tumor Burden
PubMed: 24807596
DOI: 10.1097/DCR.0000000000000070 -
Journal of Gastroenterology and... Aug 2023Currently, some countries still acknowledge double-contrast barium enema (DCBE) as a backup confirmatory examination when colonoscopy is not feasible or incomplete in...
Double-contrast barium enema is no longer justified as a backup examination for colonoscopy in the population screening program: Population study in an organized fecal immunochemical test-based screening program.
BACKGROUND AND AIM
Currently, some countries still acknowledge double-contrast barium enema (DCBE) as a backup confirmatory examination when colonoscopy is not feasible or incomplete in colorectal cancer (CRC) screening programs. This study aims to compare the performance of colonoscopy and DCBE in terms of the risk of incident CRC after negative results in the fecal immunochemical test (FIT)-based Taiwan Colorectal Cancer Screening Program.
METHODS
Subjects who had positive FITs and received confirmatory exams, either colonoscopy or DCBE, without the findings of neoplastic lesions from 2004 to 2013 in the screening program comprised the study cohort. Both the colonoscopy and DCBE subcohorts were followed until the end of 2018 and linked to the Taiwan Cancer Registry to identify incident CRC cases. Multivariate analysis was conducted to compare the risk of incident CRC in both subcohorts after controlling for potential confounders.
RESULTS
A total of 102 761 colonoscopies and 5885 DCBEs were performed after positive FITs without neoplastic findings during the study period. By the end of 2018, 2113 CRCs (2.7 per 1000 person-years) and 368 CRCs (7.6 per 1000 person-years) occurred in the colonoscopy and DCBE subcohorts, respectively. After adjusting for major confounders, DCBE had a significantly higher risk of incident CRC than colonoscopy, with an adjusted HR of 2.81 (95% CI = 2.51-3.14).
CONCLUSIONS
In the FIT screening program, using DCBE as a backup examination was associated with a nearly threefold risk of incident CRC compared with colonoscopy, demonstrating that it is no longer justified as a backup examination for incomplete colonoscopy.
Topics: Humans; Barium Sulfate; Barium Enema; Enema; Colonoscopy; Colorectal Neoplasms; Occult Blood; Early Detection of Cancer; Mass Screening
PubMed: 37078599
DOI: 10.1111/jgh.16191 -
Frontiers in Pediatrics 2022Preoperative evaluation of the dysganglionic bowel segment is critical for establishing the optimal resection strategy for Hirschsprung's disease (HSCR), which...
BACKGROUND
Preoperative evaluation of the dysganglionic bowel segment is critical for establishing the optimal resection strategy for Hirschsprung's disease (HSCR), which facilitates patient outcomes.
OBJECTIVE
We set out to determine the utility of the 24-h delayed film of barium retention in predicting the length of dysganglionic bowel segment in HSCR.
MATERIALS AND METHODS
A retrospective study of patients with clinically suspicious HSCR who underwent a preoperative 24-h delayed film of barium enema and were surgically treated from January 2015 to December 2019 was conducted.
RESULTS
Two hundred and 58 patients were enrolled in this study. The sensitivity, specificity, positive and negative predictive values (NPVs) of the 24-h delayed film of barium enema to predict the neuropathological segment were 89.1, 91.5, 91.3, and 89.4%, respectively. The Youden index was 80.6%, with a kappa value of 0.806 ( < 0.001). The correlation rate between barium retention level and pathological results was 72.7% (16/22) when aganglionosis was restricted within the mid-distal rectum (short-segment type), increasing to 92.0% (46/50) and 93.5% (174/186) for patients that had aganglionosis extended beyond the mid-distal rectum (classical type) and sigmoid colon (long-segment type), respectively. Lastly, patients younger than 3 months showed a lower correlation rate (72.2%) compared to patients aged 3-12 months (91.0%) and > 12 months (92.6%).
CONCLUSIONS
Our investigation of the 24-h delayed film of barium enema performed for patients suspected of having HSCR indicated that the barium retention level remains crucial in predicting dysganglionic bowel segment, which contributes to the decision-making for surgical physicians.
PubMed: 36204664
DOI: 10.3389/fped.2022.979149 -
Postgraduate Medicine Jul 1996
Topics: Barium Sulfate; Colonic Neoplasms; Enema; Humans
PubMed: 8668622
DOI: 10.1080/00325481.1996.11444172