[Relationship between the radiological length of the opaque enema and the aganglionic length of the segment in Hirschsprung's disease]. / Relación entre la longitud radiológica del enema opaco y la longitud agangliónica de la pieza en la enfermedad de Hirschsprung.

ABSTRACT

INTRODUCTION: Barium enema was the first method used for the diagnosis of Hirschsprung's disease, with the appearance of anorectal manometry and its combination with rectal suction biopsy, barium enema has lost value as a diagnosis method but it has also gain importance to decide the surgical technique that will be used for the correction of the disease. AIM: To determine the correlation between the length of the affected segment showed by barium enema valued and the length of the removed piece. MATERIALS AND METHODS: We have studied all Hirschsprung disease's cases diagnosed and treated in our center since 1998, 127 patients underwent Soave-Boley's technique and 51 De La Torre's descent technique. Routinely preoperative barium enema was performed in all cases and determine the location of the transition zone and compared with the aganglionic segment's length specified by pathologist. RESULTS: At 90% of cases the transition zone could be seen at barium enema, it's most common location was rectosigmoid. After statistically analysis the length measured at radiology tests and the length of the anatomic piece showed a low correlation (kappa index 0.0159), being highest values at rectosigmoid transition and very low values at long affected segments. CONCLUSIONS: Barium enema in Hirschsprung's disease is valuable to decide the best surgical technique in each singular case but not to determine the exact length of affected segments. In case of a aganglionic long-segment suspicion, biopsies may be necessary to determinate preoperative length of affected segments.