A Critical Analysis of Rectal Biopsy to Exclude Hirschsprung's Disease

Study of 187 children found that 78% of rectal biopsies performed to diagnose Hirschsprung's disease were negative, with most requiring invasive open biopsy. While absence of risk factors ('red flags') predicted non-HD with 91% accuracy, this alone was insufficient to safely exclude the diagnosis, highlighting the need for better diagnostic strategies.