• Journal of Veterinary Clinics
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• v.25 no.6
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• pp.549-552
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• 2008

An eight-month-old, intact female Jindo, weighing 9 kg with a one-day history of acute bloody diarrhea was referred. Plain abdominal radiographic findings included evidence of a soft tissue tubular mass within the dilated colon. In ultrasonographs, a target-like mass was identified with multiple hyperechoic and hypoechoic parallel wall layers. A barium enema showed a large radiolucent filling defect within the colon and a completely occlusive lumen. On the basis of these images, ileocecocolic and colocolic intussusception was diagnosed. Surgical manual reduction, resection and anastomosis were performed. The patient recovered normally without any complications or recurrence.

• Advances in pediatric surgery
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• v.7 no.2
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• pp.105-111
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• 2001

To investigate the diagnostic accuracy and applicability of barium enema(BE) and rectal suction biopsy with acetyl cholinesterase(AChE) histochemistry in the diagnosis of neonatal Hirschsprung's disease(HD), we retrospectively reviewed the findings of BE and AChE staining in 96 neonates with suspected HD during a 10-year period from January 1991 to December 2000. Sixty-nine cases of HD(58 males and 11 females) and 27 cases of non-HD are included in this study. In regard to BE, HD was based on definite transitional zone, suspicious HD on reversed rectosigmoid index(RSI <1), and non-HD on normal RSI(RSI>1). The histochemical criterion used for the diagnosis of HD was that of Chow et al(1977), i.e., the presence of many coarse discrete cholinergic nerve fibers in the muscularis mucosae and in the immediately subjacent submucosa regardless of infiltration of cholinergic nerve fibers in the lamina propria. Of 66 neonates with HD who underwent BE, transitional zone was identified in 33 cases(50 %) and reversed RSI in 19 cases(21 %), microcolon in 4 cases and normal finding in 10 cases(15 %) while of 27 neonates with non-HD, there was normal finding in 16 cases and reversed RSI in 9 cases(41 %). Thus diagnostic accuracy based on transitional zone was 64 %. The positive predictive value of reversed RSI for the diagnosis of HD was 68 %. Of 42 neonates with HD who underwent AChE histochemistry, there were 41 AChE-positive reactions and one AChE-negative reaction in a neonate with total colonic aganglionosis, while of 27 cases of non-HD, there were one equivocal AChE-positive reaction and 26 AChE-negative reactions. Thus AChE histochemical study showed a 97 % diagnostic accuracy with a 98 % sensitivity and a 96 % specificity. In conclusion, we believe that BE is valuable as a first diagnostic step since about 80 % of neonates with HD show significant radiologic findings such as a transitional zone or reversed RSI. AChE histochemical study was a more reliable diagnos tic tool showing a 97 % diagnostic accuracy, and is part.

• The Korean Nurse
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• v.29 no.3
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• pp.25-35
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• 1990

It is a fact that there are recent increasing trends or incidence of the colorectal carcinoma among other colorectal diseases. In such trend, the early detection remain to be most important by the air contrast barium enema and total colonofiberscopy. There are several ways to prepare the colon for barium enema and colonofiberscopy which include several agents. The mechanical cleansing have been used most frequently since Brown's method was adapted to be most perfect for colon deansing. The ideal laxatives and enema solutions were limited to adequate dose, it's effectiveness, patient's diet and bowel habit, minimal side effect, low cost and simple to perform. In order to compare the effectiveness of various cleansing solutions, six experimental methods were formed as shown; 1. normal saline enema, 2. castor oil with normal saline enema, 3. castor oil with soap suds enema, 4. magnesium citrate with normal saline, 5. magnesium citrate with soap suds enema and 6. ingestion of Golyetly solution. The authors have compared and determined the degree of cleanness by an experienced endoscopist. The total number of patients was 247, age distribution was $43{\pm}15$ years old, and sex distribution was 133 males and 114 females. The grade I and II represented no difficulties at performing the colonofiberscopy, but grade ill and N had some difficulties, even unable to perform the colonofiberscopy. The effectiveness the cleansing agents, represented with grade I and II was 95.9% (47/49) in method 6, 93.2%(54/58) in method 2, 83.3%(30/33) in method 3, 70.0%(28/10) in method 5, 66.7%(16/24) in method i, and 45.7%(18/40) in method 4. Method 2 and 6 were the most effective in normal bowel habit patients. In constipated patients, method 6 was the most effective and all method except method 11 were effective in diarrhea patients. The degrees of less mucosal irritation by various bowel cleansing method were in the order of method 6(100%), 1(100%), 5(74%), 2(69%). In subjective symptoms and cleansing groups, abdominal distension, pain, nausea and vomiting were complained, and that's subject symptoms were in the order of method 3(88.9%), 6 (79.6%), 1(75%), 5(72.5%), 2(72.4%), 4(67.5%). In conclusion, we believe that the Golytely of the mechanical cleansing solution for colonofiberscopy was the most effective, but others depended on the patient's condition und bowel habit.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.6 no.1
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• pp.24-31
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• 2003

Purpose: As diagnostic tools for Hirschsprung's disease (HD), barium enema and rectal biopsy have radiation exposure and invasiveness respectively; however anorectal manometry does not have these disadvantages. We therefore performed this study to evaluate the diagnostic efficacy of anorectal manometry. Methods: We reviewed medical records of infants with one or two symptoms of vomiting, abdominal distension, chronic diarrhea or constipation who had a anorectal manometry followed by barium enema and/or biopsy from July 1995 to May 2002. We evaluated the sensitivity, specificity and predictive value of anorectal manometry and barium enema for diagnosis of HD. We also measured sphincter length, median value of balloon volume at which rectoanal inhibitory reflex (RAIR) occurred. Results: All 61 patients received anorectal manometry, 33 of 61 received barium enema. 18 of 61 were diagnosed as HD according to histology and 43 of 61 were evaluated as a control. The sensitivity, specificity, positive predictive value, negative predictive value of anorectal manometry and barium enema for diagnosis of HD were 1.00, 0.91, 0.82, 1.00 and 0.93, 0.67, 0.70, 0.92 respectively. The mean value of sphincter length in control was $1.68{\pm}0.67$ cm and correlated with age, weight and significantly longitudinal length. The median value of balloon volume at which RAIR occurred was 10 mL and did not correlated with age, weight and longitudinal length. Conclusion: This study suggests that anorectal manometry is an excellent initial screening test for Hirschsprung's disease because of its safety and accuracy.

• Journal of the Korea Convergence Society
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• v.4 no.2
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• pp.9-13
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• 2013

This study which improve pretreatment method was to increase effective diagnosis of barium enema to remind a more accurate action by training precautions, method of taking medicine, time and taking suitable laxative to patient. First, A total of 504 patients who received barium enema in the E university hospital were evaluated about repretreatment proportion of patients. 176 patients who were changed with precaution were evaluated about repretreatment. Second, Both 130 patients who were not changed with the type and amount of laxative and 137 patients who were changed with it were evaluated. Repretreatment rate was reduced about 10% since changed precautions. Stomachache was reduced about 21% due to chage methode to take the laxative improved. Patients who think cleanliness degree of bowel increased that it is going very well about 11.9% since improvement and decreased that it's not bad about 16.3%. The methods which accurately recognize precautions to patient decrease repretreatment rate, inconvenience and pain of patients due to repretreatment. Expectation mentlity for accurate inspection also had increased in that patients think that cleanliness degree of bowel was increased.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.2
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• pp.194-198
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• 2009

Purpose: Severe abdominal distension is not uncommon symptom in the neonate. Two major causes of this symptom are benign transient intestinal ileus (BTII) and Hirschsprung`s disease (HD). But it is difficult to differentiate BTII from HD based on the symptoms and simple abdominal x-ray findings. The aim of this retrospective study was to assess the clinical aspects and diagnostic tests differencing two diseases. Methods: From August 2004 to March 2009, nineteen patients with severe abdominal distension, who underwent barium enema, anorectal manometry, and rectal suction biopsy (triple tests) due to a suspicion of HD, were enrolled. A comparison of clinical data associated with BTII and HD based on the clinical features and results of triple tests. Results: The age of onset of symptom was between 2 and 6 weeks in BTII and within 3 weeks in HD. On the barium enema, transitional zone revealed in 6 (50%) patients in BTII and 4 (57.1%) in HD. On anorectal manometry, the anorectal inhibitory reflex was present in 11 (91.7%) patients in BTII and 1 (14.3%) in HD. On rectal suction biopsy, ganglion cell was present in 9 (75%) patients in BTII and 0 (0%) in HD. Abdominal distension was improved within 3 months of life in all cases of BTII. Conclusion: We think that anorectal manometry may be more simple and useful diagnostic method than barium enema and rectal suction biopsy for differential diagnosis of transient intestinal ileus and Hirschsprung's disease.

• Advances in pediatric surgery
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• v.8 no.1
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• pp.1-5
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• 2002

Diagnosing Hirschsprung's disease is a clinical challenge. Hirschsprung's disease should be considered in any child who has a history of constipation dating back to the newborn period. We examined diagnostic methods and their results retrospectively in 37 neonates and infants who underwent both barium enema and anorectal manometry for the diagnosis of Hirschsprungs disease at Asan Medical Center between January 1999 and April 2001. Two radiologists and a surgeon repeatedly reviewed both of the diagnostic results. In anorectal manometry, thirty-four studies were in agreement with the definitive diagnosis, giving an overall diagnostic accuracy of 91.9 % (neonate; 100 %, infant; 85.7 %). The accuracy and specificity of barium enema was lower than those of anorectal manometry, but sensitivity was higher. There was no significant difference between the two methods. Both studies showed findings consistent with the final diagnosis. However, discordant results needed further evaluation or close observation to diagnose accurately. We conclude that Hirschsprungs disease should not be diagnosed by only one diagnostic method.

• Advances in pediatric surgery
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• v.2 no.1
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• pp.59-63
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• 1996

Colonic atresia is the least common form of intestinal atresia. Colonic atresia, like jejunoileal atresia, mostly occurs as a result of an intrauterine vascular accident. According to Sutton's classification, type 1 colonic atresia exibits external continuity with an intraluminal diaphragm(colonic web) which may be imperforate or perforate. Authors experienced a case of colonic web associated with imperforate anus. The patient was treated under the impression of the high type imperforate anus. Posterior sagittal anorectoplasty at the age of 9 months revealed normal anorectal canal. At the age of 12 months, colostomy was repaired. Thereafter abdominal distension was developed. Barium enema noted a membranous obstruction of the colon on the level of the rectosigmoid junction. After exicision of the colonic web, the patient was discharged with no problem.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.sup1
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• pp.44-54
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• 2008

Chronic functional constipation is a common problem in childhood, with soiling a significant issue. It presents a management problem for pediatrician, and parental concern is high. About 5% of pediatric patients is known to have constipation and/or encopresis which is the second most referred disease in pediatric gastroenterology clinic, accounting for up to 25% of all visits. The etiology of constipation was based on initiation factors including vicious cycle concept, genetic factors, psychological factors, dietary influences and histologic abnormalities of colon. Emphasis is placed on the evaluation and management options that are available to the treating pediatrician. Careful history taking is most important to diagnose functional constipation. In addition, diagnostic tests such as plain abdominal radiograph, colonic transit study, anorectal manometry, barium enema were helpful to diagnose the constipation. Childhood constipation can be very delicate to treat. It often requires prolonged supports by physicians and parents, demystification, medical treatment and especially with the child and parent's cooperation.

• The Korean Journal of Nuclear Medicine
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• v.32 no.2
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• pp.172-177
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• 1998

We report a case of gastro-colic fistula caused by ectopic gastric mucosa developed at transverse colon. Fistula was detected by colonofiberscopy. And fistulous tract was proved by barium enema. Meckel's diverticulum scan finding was similar to that of GI bleeding; e.g. injected radioactivity was secreted into the lumen and moved along the lumen. There was no bleeding. And there was no diverticulum in the colon. Absence of diverticular pouch may explain this unusual GI bleeding-like scan finding rather than focal collection of radioactivity, which is typical of ectopic gastric mucosa found in the Meckel's diverticulum. Ectopic gastric mucosa was confirmed by colonofiberscopic biopsy. We suggest GI bleeding-like pictures should be included in differential diagnosis of $^{99m}TcO_4$ (ectopic gastric mucosa or Meckel's diverticulum) scan.