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Updated: Jul 10, 2026

Diagnosis of Hirschsprung's Disease by Immunostaining Rectal Suction Biopsies for Calretinin, S100 Protein and Protein Gene Product 9.5
05:45

Diagnosis of Hirschsprung's Disease by Immunostaining Rectal Suction Biopsies for Calretinin, S100 Protein and Protein Gene Product 9.5

Published on: April 26, 2019

Allergic proctitis and abdominal distention mimicking Hirschsprung's disease in infants

Jee Hyun Lee1, Yon Ho Choe, Suk-Koo Lee

  • 1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Acta Paediatrica (Oslo, Norway : 1992)
|October 24, 2007
PubMed

Insights

Allergic proctitis (AP) can mimic Hirschsprung's disease (HD) in infants. Rectal suction biopsy is crucial for differentiating these conditions in infants with severe abdominal distention.

Area of Science:

  • Pediatric Gastroenterology
  • Surgical Neonatology

Background:

  • Hirschsprung's disease (HD) is a congenital condition causing intestinal obstruction.
  • Infants presenting with symptoms mimicking HD require accurate diagnosis to guide appropriate treatment.
  • Allergic proctitis (AP) can present with similar clinical features to HD, complicating diagnosis.

Purpose of the Study:

  • To investigate the incidence and clinical characteristics of allergic proctitis (AP) in infants suspected of having Hirschsprung's disease (HD).
  • To evaluate the diagnostic utility of barium enema, anorectal manometry, and rectal suction biopsy in differentiating AP from HD.

Main Methods:

  • A cohort of 105 infants under 6 months old, suspected of having HD, underwent barium enema, anorectal manometry, and rectal suction biopsy.
  • Patient characteristics were compared between diagnosed HD, AP, and normal cases.
  • Sensitivity and specificity of the diagnostic tests for HD were calculated.

Main Results:

  • Of 105 infants, 37.1% were diagnosed with HD, 6.7% with AP, and 50.5% had normal findings.
  • AP patients were older (mean 3.1 months) than HD patients (mean 1.4 months).
  • Rectal suction biopsy demonstrated high sensitivity (97.4%) and specificity (100%) for diagnosing HD.

Conclusions:

  • Allergic proctitis (AP) occurs with a notable incidence in infants presenting with symptoms suggestive of HD.
  • AP should be considered in the differential diagnosis of infants with severe abdominal distention or HD-like findings.
  • Rectal suction biopsy is a valuable tool for distinguishing between AP and HD in infants.
Abstract

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