{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T19:37:59Z","timestamp":1781552279867,"version":"3.54.5"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,1,8]],"date-time":"2024-01-08T00:00:00Z","timestamp":1704672000000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Hirschsprung's disease (HSD) remains a common cause of pediatric intestinal obstruction. Barium contrast enema (BE) is the primary imaging modality for the evaluation of clinically suspected cases. Here, we aimed to assess the diagnostic accuracy of BE in children with clinically suspected HSD when compared to a gold standard full\u2010thickness rectal biopsy (FTRB).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We recruited and consecutively enrolled children with clinically suspected HSD at two tertiary teaching hospitals. Participants underwent BE imaging and two radiologists interpreted the findings independently. Participants further underwent FTRB by pediatric surgeons as the confirmatory test. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and receiver operating characteristics (ROC) with the area under the curve (AUC) were calculated on Stata version 14.2, taking FTRB as the standard.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We enrolled 55 cases, of which 49 completed the evaluation and were included in the final analysis. The median age was 9.4 months (interquartile range: 2\u201324], with a male\u2010to\u2010female ratio of 4.4:1. The sensitivity, specificity, PPV, and NPV of BE were 0.95 (95% confidence interval [CI]\u00a0[0.81\u20130.99]), 0.73 (95% CI [0.39\u20130.94]), 0.92 (95% CI [0.82\u20130.97]), and 0.80 (95% CI [0.50\u20130.94]), respectively. On AUC, the diagnostic accuracy of BE compared to the confirmatory FTRB was 0.84 (95% CI [0.69\u20130.98]). The diagnostic accuracy was higher in neonates (ROC: 1.00) when compared to infants (ROC: 0.83) or those above 1 year of age (ROC: 0.798). HSD\u2010suggestive BE findings were associated with absence of ganglion cells on FTRB (<jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200923.301,<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Inverted rectosigmoid ratio and transition zone were more sensitive in detecting HSD of 0.92 (95% CI [0.74\u20130.98]) and 0.81 (95% CI [0.63\u20130.92]), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>BE is sufficiently accurate in the diagnosis of children with HSD, suggesting BE would likely be used to inform surgical management in settings where confirmatory biopsy is lacking. However, clinical judgment is warranted in interpreting negative BE findings.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hsr2.1798","type":"journal-article","created":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T05:07:12Z","timestamp":1704776832000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Diagnostic accuracy of barium enema versus full\u2010thickness rectal biopsy in children with clinically suspected Hirschsprung's disease: A\u00a0comparative cross\u2010sectional study"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4304-804X","authenticated-orcid":false,"given":"Tesfahunegn","family":"Hailemariam","sequence":"first","affiliation":[{"name":"Department of Radiology, College of Health Sciences Addis Ababa University Addis Ababa Ethiopia"},{"name":"Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT\u2010AFRICA), College of Health Sciences Addis Ababa University Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abenezer Kebede","family":"Bekele","sequence":"additional","affiliation":[{"name":"Department of Radiology St. Peter's Specialized Hospital Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsegahun","family":"Manyazewal","sequence":"additional","affiliation":[{"name":"Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT\u2010AFRICA), College of Health Sciences Addis Ababa University Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Zewdneh","family":"Solomon","sequence":"additional","affiliation":[{"name":"Department of Radiology, College of Health Sciences Addis Ababa University Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yocabel","family":"Gorfu","sequence":"additional","affiliation":[{"name":"Department of Radiology, College of Health Sciences Addis Ababa University Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zelalem","family":"Shiwarega","sequence":"additional","affiliation":[{"name":"Department of Radiology Vision Speciality Clinic Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tewodros","family":"Getinet","sequence":"additional","affiliation":[{"name":"School of Public Health St. Paul's Hospital Millennium Medical College Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meti","family":"Wole","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Armed Forces Comprehensive Specialized Hospital Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samrawit","family":"Solomon","sequence":"additional","affiliation":[{"name":"School of Public Health St. Paul's Hospital Millennium Medical College Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5543-3215","authenticated-orcid":false,"given":"Samuel Sisay","family":"Hailu","sequence":"additional","affiliation":[{"name":"Department of Radiology, College of Health Sciences Addis Ababa University Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,8]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2023.01.001"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12519-023-00686-x"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0043-1760839"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sempedsurg.2022.151163"},{"key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"275","DOI":"10.4103\/jiaps.jiaps_6_22","article-title":"Hirschsprung's disease: perspectives upon late 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