الفهرس 
Radiological Anatomy of the Large BowelOnly 14 pages are availabe for public view
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Abstract
hirschsprung disease (HD) is a relatively common cause of intestinal obstruction in newborn infants. It is characterized by the absence of ganglion cells in the distal bowel, which begins at the level of the internal anal sphincter and extends proximally for varying distances. The absence of ganglion cells has been attributed to the failure of migration of neural crest cells.
Although contrast enema remains the gold standard for imaging of suspected patients with Hirschsprung disease, the use of ultrasound in assessment of gastrointestinal tract diseases has increasing role worldwide.
from September 2019 to February 2023, this study was conducted on 30 patients less than 2 years with history of chronic constipation and delayed meconium passage and referred as suspecting Hirschsprung disease obtained from the radiodiagnosis department, faculty of medicine, Ain Shams University.
All patients were subjected to pelviabdominal ultrasound after rectal catheterization without ballon inflation and saline injection for evaluation recto sigmoid ratio, transition zone and bowel wall thickness and the same patients were subjected also to gastrografin enema.
Results were compared between ultrasound and gastrografin enema findings and also were compared by biopsy results.
The study showed that there was no statistically significant difference between ultrasound and gastrografin enema in diagnosis of Hirschsprung disease (p value = 1) with an overall kappa measure of agreement of 0.73, a sensitivity of ultrasound was 87.5% and specificity was 85.7% and accuracy of ultrasound of 86.7%
When ultrasound results compared to biopsy results, the sensitivity was 97.8 % and specificity was 50% and accuracy was 88.9%
The results of gastrografin enema when compared to biopsy results were nearly the same as ultrasound results.
In conclusion ultrasound can be used as an alternative screening method to contrast enema in diagnosis of Hirschsprung disease as it is a simple, safe, widely available, costly saving, non invasive diagnostic tool with no usage of contrast material and no exposure to ionizing radiation. with both high sensitivity and specificity.