Mahmuda Monowara
Shishu children hospital, Bangladesh
Abstract Title:
Sensitivity and Specificity of Barium Enema in the Radiological Diagnosis of Hirschsprung Disease in Children in a Tertiary Pediatric Hospital
Biography:
Dr.Mahmuda Monowara
Is a specialist in Radiology and imaging .She completed her MBBS from
Armed forces medical college, Dhaka Bangladesh in 2005, M.Phil. in Radiology and imaging from Dhaka University (Medical faculty) in the year 2010.She has 15 publications in different national and international journals. Working at Bangladesh Shishu (children) hospital (only tertiary children hospital of Bangladesh) from 2011 to till date.
Research Interests:
Hirschsprung disease (HSCR) is a congenital disorder characterized by the absence of ganglion cells in the distal bowel, leading to functional obstruction. Although rectal biopsy is the gold standard, barium enema remains a widely used diagnostic tool in pediatric radiology, particularly in resource-constrained settings. This study aimed to assess the sensitivity, specificity, and diagnostic performance of barium enema findings in diagnosing HSCR using histopathology as the reference standard.
Methods:
This cross-sectional observational study was conducted at the Department of Radiology and Imaging, Bangladesh Shishu Hospital & Institute, Dhaka, Bangladesh, from January 2021 to December 2024. A total of 150 children with suspected HSCR underwent barium enema, followed by confirmatory rectal biopsies. The radiological features, including the transitional zone, rectosigmoid index (RSI) <1, and 24-hour retention films, were analyzed. Statistical analyses were performed using SPSS v25.0.
Results:
Among the 150 participants, 73.3% were male and 44.7% were less than one month old. Clinically, constipation (80.7%), abdominal distension (78.7%), and delayed meconium passage (76.7%) were the most common symptoms. The 24-hour retention film showed the highest sensitivity (92.5%) and specificity (91.4%), followed by the transitional zone (87.3%, 90.1%), and RSI <1 (75.9%, 88.7%). Diagnostic accuracy was highest in children aged 1–12 months and in patients with short-segment disease.
Conclusion:
Barium enema, particularly the 24-hour delayed film, demonstrates high diagnostic accuracy and remains a suitable noninvasive tool for evaluating HSCR in children in resource-limited settings.
