Is the appendix a good organ to diagnose total colonic aganglionosis?
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Read the article on link.springer.com ↗Article · Jan 2022 · 1 min read
In brief
In brief
Study validates appendix biopsy as reliable diagnostic tool for total colonic aganglionosis (TCA). Review of 112 appendix specimens showed 100% sensitivity and specificity: ganglion cells absent in all TCA cases, present in all non-TCA controls including short-segment Hirschsprung disease.
Written by the GCMD Library team from the article.
Abstract
Purpose
The use of the appendix for diagnosis of Total Colonic Aganglionosis (TCA) remains controversial. This study aimed to categorize the presence of ganglion cells in the appendix and determine its reliability as a histological specimen for the diagnosis of TCA.
Methods
This was a combined retrospective and prospective study. Permanent histological specimens of normal appendices removed during appendectomy for malrotation or falsely presumed appendicitis, and from patients with short segment Hirschsprung’s disease (HD) or TCA were included. Permanent specimens of the appendix tip from Malone procedures were prospectively collected. All specimens were independently reviewed by two experienced pathologists in a standardized manner to assess for the presence of ganglion cells.
Results
A total of 112 appendices were evaluated. Nine came from patients with a diagnosis of TCA, and five from patients with HD. Ganglion cells were present in all specimens from patients with diagnoses other than TCA and were absent in all specimens from patients with TCA.
Conclusion
In the correct clinical setting, the absence of ganglion cells in the appendix can allow for a reliable diagnosis of TCA.