2003-12-11
4149684, 신O용,M/0
2003-12-16
2003-12-17
2003-12-24
POD#1
2004-01-01
2004-01-07
POD#7
Radiologic review of Hirschsprung’s
disease
Functional disorders of the colon
Radiologic findings
1.Constipation,
2.Obstruction,
3.Both without a mechanical defect
Colonic Aganglinosis
(Hirschsprung’s disease)
Plain films
Obstruction site
Distal colonic obstruction : typical
Proximal colon : Partial small bowel obstruction -confuse
Stool Content
Extensive amounts : Proximal dilated colon.
Empty of stool : Distal colon
Immediately after contrast enema
Distended bowel loops fill almost
Delayed films
Delayed evacuation of barium :Retention at 48hrs
Mixed barium-stool pattern
Contrast Study
Contrast agents
Barium or Water-soluble
Water-soluble media : more commonly used
Retain barium for extended periods of time
Therapeutic if functional constipation.
Preparation
Do not
:Presence of stool in the dilated portion of the bowel the
- Identification of a Transition zone easier.
Findings
Transion zone : rectosigmoid
Between narrowed,stool-free aganglionic distal segment
and dilated,stool-filled proximal segment.
Thickening and nodularity of colonic mucosa
on Proximal to transition zone.(rare)
Abnormal irregular contraction waves (20%)
Smooth or Spiky
Contraindication
Hirschsprung-associated enterocolitis
Sx. & Sign : Fever,abdominal distention,diarrhea,and sepsis.
Water-soluble contrast enemas
Findings
Plain films
Intestinal distention with air-fluid levels
Look for evidence of intestinal perforation
US
Thickened bowel wall and ascites.