{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T19:04:53Z","timestamp":1788030293421,"version":"build-2784847793"},"reference-count":25,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[1999,11,1]],"date-time":"1999-11-01T00:00:00Z","timestamp":941414400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatr Dev Pathol"],"published-print":{"date-parts":[[1999,11]]},"abstract":"<jats:p>Diagnostic pathologists remain uncomfortable with the diagnosis of Hirschsprung disease (HD) via rectal (mucosal\/submucosal) biopsy and with performance and interpretation of the associated acetylcholinesterase (AChE) assay. This report details the different diagnostic approaches taken by four major pediatric institutions\u2014 Children's Hospital, Columbus, OH; Children's Hospital Medical Center, Cincinnati, OH; Children's Hospital, Pittsburgh, PA; Children's Hospital, Los Angeles, CA\u2014in confirming or excluding the presence of HD. The Columbus approach emphasizes serial morphologic examination of rectal biopsies, while Cincinnati emphasizes the primary diagnostic utility of the AChE stain. Pittsburgh and Los Angeles emphasize a detailed gross and microscopic analysis of rectal biopsies to detect both conventional HD and its more rare subtypes.<\/jats:p>\n                  <jats:p>The diagnostic approaches of these four institutions can be used on a complementary basis to the advantage of the general diagnostic pathologist, especially in HD cases with subtle clinical presentations. The need for careful and continual communication between the clinician and pathologist in diagnosing or excluding the presence of HD is imperative.<\/jats:p>","DOI":"10.1007\/s100249900167","type":"journal-article","created":{"date-parts":[[2002,7,25]],"date-time":"2002-07-25T02:40:57Z","timestamp":1027564857000},"page":"588-596","source":"Crossref","is-referenced-by-count":65,"title":["Diagnosis of Hirschsprung Disease Using the Rectal Biopsy: Multi-institutional Survey"],"prefix":"10.1177","volume":"2","author":[{"given":"Stephen J.","family":"Qualman","sequence":"first","affiliation":[{"name":"Wexner Institute for Pediatric Research, W412, Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Jaffe","sequence":"additional","affiliation":[{"name":"Department of Pathology, Children's Hospital, 3705 Fifth Avenue, Pittsburgh, PA 15213, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin E.","family":"Bove","sequence":"additional","affiliation":[{"name":"Department of Pathology, HT-4, Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hector","family":"Monforte-Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Department of Pathology, Children's Hospital Los Angeles, Box 43, 4650 Sunset Boulevard, Los Angeles, CA 90027, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[1999,11,1]]},"reference":[{"key":"bibr1-s100249900167","doi-asserted-by":"publisher","DOI":"10.1016\/0046-8177(94)90030-2"},{"key":"bibr2-s100249900167","doi-asserted-by":"publisher","DOI":"10.1159\/000061920"},{"key":"bibr3-s100249900167","doi-asserted-by":"publisher","DOI":"10.3109\/15513818409041186"},{"key":"bibr4-s100249900167","doi-asserted-by":"publisher","DOI":"10.1016\/S0046-8177(83)80179-8"},{"key":"bibr5-s100249900167","first-page":"319","volume":"16","author":"Ballard ET","year":"1996","journal-title":"Pediatr Pathol Lab Med"},{"key":"bibr6-s100249900167","first-page":"329","volume":"100","author":"Yunis EJ","year":"1976","journal-title":"Arch Pathol Lab Med"},{"key":"bibr7-s100249900167","doi-asserted-by":"publisher","DOI":"10.1080\/15513819709168584"},{"key":"bibr8-s100249900167","first-page":"721","volume":"122","author":"Monforte-Mu\u00f1oz H","year":"1998","journal-title":"Arch Pathol Lab Med"},{"key":"bibr9-s100249900167","doi-asserted-by":"publisher","DOI":"10.1097\/00008480-199506000-00014"},{"key":"bibr10-s100249900167","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(97)90187-1"},{"key":"bibr11-s100249900167","doi-asserted-by":"publisher","DOI":"10.1007\/s003830050264"},{"key":"bibr12-s100249900167","doi-asserted-by":"publisher","DOI":"10.1007\/BF01194812"},{"key":"bibr13-s100249900167","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3468(69)90607-1"},{"key":"bibr14-s100249900167","doi-asserted-by":"publisher","DOI":"10.1007\/BF00166866"},{"key":"bibr15-s100249900167","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM196505132721903"},{"key":"bibr16-s100249900167","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(81)80001-2"},{"key":"bibr17-s100249900167","doi-asserted-by":"publisher","DOI":"10.1080\/15513819709168584"},{"key":"bibr18-s100249900167","first-page":"244","volume":"103","author":"Lake BD","year":"1978","journal-title":"An appraisal of histochemically demonstrated acetylcholinesterase activity in suction rectal biopsy specimens as an aid to diagnosis. 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