The place of rectal submucosal punch biopsy in definitive diagnosis of Hirschsprung's disease [Hirschsprung hastaliginin kesin tanisinda rektal submukozal biyopsinin yeri]

Purpose: Full thickness rectal biopsy is still the popular definitive diagnostic method for Hirschsprung's disease (HD). The purpose of this study is to compare rectal punch biopsy (RPB) with full thickness rectal biopsy (FTRB) in the diagnosis of Hirschsprung's disease. Methods: RPB and FTRB materials of 20 children with a presumptive diagnosis of HD were evaluated retrospectively. RPB were taken in an out-patient basis using a special designed rectal tube and a laryngeal punch biopsy forceps. After routine preparations, all the biopsy specimens were examined under light microscope. Submucosal plexus in RPB, submucosal and myenteric plexus in FTRB materials were investigated for the presence of ganglion cells. Results: 15 RPB materials showed absence of ganglion cells. Ganglion cells were positive in remaining five RPB materials. There was no difference between the findings of RPB and FTRB materials of each patient. Conclusion: This pilot study suggests that, RPB is a safe and cheap method without anesthesia and operating room necessity