Accuracy of transition zone in contrast enema to predict intraoperative aganglionosis level in patients with Hirschsprung disease.

We recruited 36 HSCR patients: twenty-six patients (72.2%) had radiographic transition zones limited to rectum, while ten subjects (27.8%) were limited to rectosigmoid. The rectum subgroup of patients showed a concordance of 30.8%, whereas the rectosigmoid subgroup had a concordance of 100%. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of contrast enema compared with intraoperative histopathological findings for aganglionosis level were 100% (95% CI 0.60-1.0), 35.7% (95% CI 0.19-0.56), 30.8% (95% CI 0.15-0.52), 100% (95% CI 0.66-1.0), and 50% (95% CI 0.33-0.67), respectively. In conclusions, contrast enema has low accuracy to predict intraoperative aganglionosis segments in HSCR patients, indicating that it might not be utilized to determine aganglionosis level during TEPT.