Hirschsprung's disease other imaging findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

A barium enema is the mainstay of diagnosis of Hirschsprung’s disease. Barium enema findings suggestive of Hirschsprung's disease include:

Other Imaging Findings

Barium Enema

Barium enema findings suggestive of Hirschsprung's disease include:

• Radiography performed in children with Hirschsprung disease yields findings similar to those in other forms of low small bowel obstruction: variable gaseous distention of the colon and small bowel, often with air-fluid levels.
• The colon is usually difficult to identify accurately, and gas is usually absent in the rectum.
• Barium enema studies demonstrate patency of the colon, which is short but usually normal in caliber.
• A transition zone between the narrow and dilated portions of the colon in the shape of an inverted cone is the most characteristic radiologic finding.
• When this transition zone is observed, the examination should be discontinued because filling of the more proximal dilated bowel beyond the transition zone may lead to impaction.
• The radiologic diagnosis of total colonic aganglionosis is difficult. Findings at barium enema examination may be normal or may include a short colon of normal caliber, microcolon, or a transition zone in the ileum.

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