The evaluation of rectal mucosal punch biopsy in the diagnosis of Hirschsprung’s disease: a 30-year experience of 954 patients

Abstract

Punch biopsy including the "K-PUNCH" method is considered safe and feasible and is associated with a low rate of complications and inappropriate specimen harvesting among patients of all ages. Comorbidities, including the potential for hemorrhage, should always be considered.

Reevaluation of concurrent acetylcholinesterase and hematoxylin and eosin staining for Hirschsprung’s disease

“…The indications for a rectal mucosal biopsy were as follows: the presence of a symptom indicating intestinal obstruction, such as a bilious vomiting, chronic constipation, and abdominal distension; the presence of dilatation of the intestine on radiography; and the obvious or suspected presence of a “caliber change” indicating the transit zone of HD in a contrast enema. Manometry was not performed as a routine examination 26 …”

“…Rectal mucosal punch biopsies, including our original “K‐PUNCH” rectal mucosal punch biopsies, have been performed consecutively in our department and branch hospital 24,26 . Two to four biopsy specimens per patient were obtained, and an AChE histochemistry and HE staining was conducted.…”

“…For AChE histochemistry, after the specimens were immediately frozen in liquid nitrogen, they were stored in a deep freezer until the examination. Our technique for AChE histochemistry, which a modified version of the method reported by Karnovsky and Roots, used rubeanic acid as an amplifier 15,16,24‐26 …”

“…We started to use the results of a single AChE histochemistry test for the diagnosis of HD in 1963, and AChE histochemistry came to be included as a diagnostic option for intestinal neuronal dysplasia type B (IND‐B) in the 1990s 16,24‐26 . The sensitivity and specificity of AChE staining for the diagnosis of HD in our department have been reported as follows: Nakao et al 16 .…”

Rectal EMR for enteric ganglia: Is deeper better?

“…The "K-punch," a safe and feasible punch biopsy technique that uses rigid sigmoidoscopy, allows for visualization of the biopsy site and direct grasping sensation. 7 In another study, Ali et al 8 compared the adequacy of specimen size with standard RSB versus wall-suction or machine-suction RSB and found that 81.0% of the standard group had adequate samples when compared with 100% of the wall-suction or machine-suction RSB group (P Z .02). Also, there were no adverse events.…”