Suction Rectal Biopsy Provides Accurate Diagnosis of Hirschsprung’s Disease in Neonates
Recent literature, including a European survey, has reported concerns over the accuracy of suction rectal biopsy (SRB) to diagnose Hirschsprung’s disease in neonates, leading a good proportion of healthcare providers to favor use of more invasive full-thickness transanal biopsies, which have been associated with bleeding, scarring, and the need for general anethesia. However, a single-institution retrospective review by a group of Utah physicians found that SRB resulted in adequate tissue for evaluation of Hirschsprung’s disease in nearly all of their patients aged <6 months of age on the first attempt and that it was highly accurate in both preterm (even those weighing <2500 g) and newborn infants.
The study included 153 patients and a total of 159 SRBs. Among these patients, 43 patients were diagnosed with Hirschsprung’s disease. A second SRB was required in 6 patients (3.9%) secondary to an inadequate tissue sample. No complications with SRB were reported. Sensitivity and specificity of SRB was 100% across all age groups (ie, preterm, term neonate, infant). About 50% of patients with a negative SRB were followed for at least 1 year and none received a subsequent diagnosis of HD.
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Allen AR, Putnam AR, Presson AP, Allen CM, Barnhart DC, Rollins MD. Accuracy of Suction Rectal Biopsy for Diagnosis of Hirschsprung’s Disease in Neonates. Eur J Pediatr Surg. 2018 Aug 1. doi: 10.1055/s-0038-1667040.