Suction rectal biopsy in the diagnosis of Hirschsprung's disease and chronic constipation

Abstract

Suction rectal biopsy has gained increased acceptance as the means of definitively diagnosing Hirschsprung's disease as well as excluding this diagnosis when evaluating the child with chronic constipation. During the 11-year period from 1 July 1974 through 30 June 1985 at the University of Michigan, Mott Children's Hospital, 309 suction rectal biopsy specimens were evaluated. Of these, 293 were done for the evaluation of chronic constipation and/or Hirschsprung's disease. The remaining 16 were performed as a part of the work-up in patients with neuromuscular, glycogen storage, inflammatory bowel, or other diseases. Forty-two (14%) of the 293 patients were diagnosed as having Hirschsprung's disease at an average age of 14.4 months. This diagnosis was ruled out in the remaining 251 patients, whose age at biopsy averaged 2.7 years. There was one false-negative reading representing an incidence of 0.3%, with no false-positives. There were no complications. The suction rectal biopsy is a bedside or clinic procedure that reliably provides pathologic material adequate for the accurate diagnosis or exclusion of Hirschsprung's disease and offers a number of advantages over manometric, radiographic, histochemical, and open, full-thickness biopsy techniques.