Abstract
The majority of cases of aganglionosis present and can be diagnosed in the neonatal period. Enterocolitis is a common and fatal complication so that early diagnosis is important. The plain films and enema features of 47 cases diagnosed in the neonatal period were examined. Except when a bowel wash out had been given, all these cases showed obstructive fluid levels in the plain films and the common type of short segment aganglionosis gave an “egg on end” appearance of low small bowel obstruction in the inverted lateral view. The classical enema features take time to develop and the narrowed aganglio wic area is not always obvious but can be shown by a careful technique of slow filling with delayed films. A high degree of accuracy was obtained except in the cases of preliminary lavage, enterocolitis and meconium plug. To make an early correct diagnosis, it is important to have close correlation between clinicians, radiologists, and pathologists.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Bell, R. S., Graham, C. B., Stevenson, J. K.: Roentgenologic and clinical manifestations of neonatal necrotising enterocolitis. Amer. J. Roentgenol.112, 123–134 (1971).
Berdon, W. E., Baker, D. H.: The roentgenographic diagnosis of Hirschsprung's disease in infancy. Amer. J. Roentgenol.93, 432–446 (1965).
Berdon, W. E., Koontz, P., Baker, D. H.: The diagnosis of colonic and terminal ilial aganglionosis. Amer. J. Roentgenol.91, 680–689 (1964).
Berman, C. Z.: Roentgenographic manifestations of congenital megacolon (Hirschsprung's disease) in early infancy. Pediatrics18, 227–238 (1956).
Bughaighis, A. G., Emery, J. L.: Functional obstruction of the intestine due to neurological immaturity. In: Progress in pediatric surgery, Vol. 3. Eds. Rickham, P. P., Hecker, W. C., Prevot, T., München, Berlin, Wien: Urban und Schwarzenberg 1971.
Chandler, N. W., Zwiren, G. T.: Complete reflux of the small bowel of total colon Hirschsprung's disease. Radiology94, 335–339 (1970).
Chrispin, A. R.: Personal Communication, 1973.
Cremin, B. J.: The radiological assessment of anorectal anomalies. Clin. Radiol.22, 239–250 (1971).
Cremin, B. J., Cywes, S., Louw, J. H.: A rational radiological approach to the surgical correction of anorectal anomalies. Surgery71, 801–806 (1972).
Cremin, B. J., Cywes, S., Louw, J. H.: The radiological diagnosis of digestive tract disorders in the newborn. London: Butterworths, 1973.
Cremin, B. J., Smythe, P., Cywes, S.: The radiological appearance of the inspissated milk syndrome, a cause of intestinal obstruction in infants. Brit. J. Radiol.43, 656–858 (1970).
Cremin, B. J.: Functional intestine obstruction in premature infants. Pediat. Radiol.1, 109–112 (1973).
Deffrenne, P., Daudet, M., Chappuis, J. P.: Radiological diagnosis of total aganglionosis of the colon. Ann. Radiol.14, 257–264 (1971).
Ehrenpreis, T.: Hirschsprung's disease. pgs. 62–63, 71–78, 81–82, Chicago: Year Book. Medical Publishers Inc. 1970.
Frech, R. S.: Aganglionosis involving the entire colon and a variable length of small bowel. Radiology90, 249–257 (1968).
Hope, J. W., Borns, P. F., Berg, P. K.: Roentgenologic manifestations of Hirschsprung's disease in infancy. Amer. J. Roentgenol.95, 217–229 (1965).
Klein, R. R., Scarborough, R. A.: Hirschsprung's disease in newborn. Amer. J. Surg.88, 6–16 (1954).
Lawson, J. O. N., Nixon, H. H.: Anal canal pressures in the diagnosis of Hirschsprung's disease. J. pediat. Surg.2, 544–552 (1967).
Lillie, J. G., Chrispin, A. R.: Hirschsprung's disease in the neonate. Ann. Radiol.14, 265–270 (1971).
McDonald, R. G., Evans, W. A., Jr.: Hirschsprung's disease. Roentgen diagnosis in infants. Amer. J. Dis. Childh.87, 575–585 (1954).
Nuss, D.: Personal Communication 1972.
Sane, S. M., Girdany, B. R.: Total aganglionosis coli. Clinical and roentgenographic manifestations. Radiology107, 397–404 (1973).
Schey, W. L., White, H.: Hirschsprung's disease: Problems in the roentgen interpretation. Amer. J. Roentgenol.112, 105–115 (1971).
Tobon, F., Reid, N. c. R. W., Talbert, J. L., Schuster, M. M.: Non-surgical test for the diagnosis of Hirschsprung's disease. New Engl. J. Med.278, 188–194 (1968).
Wyllie, G. G.: Treatment of Hirschsprung's disease by Swenson's operation. Lancet1957I, 850–855.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Cremin, B.J. The early diagnosis of Hirschsprung's disease. Pediatr Radiol 2, 23–28 (1974). https://doi.org/10.1007/BF00972843
Issue Date:
DOI: https://doi.org/10.1007/BF00972843