285 Routinecontrastenemapriortostomareversalseemsonlyrequiredfollowingtreatmentfornecrotizingenterocolitis:Anevaluationofthediagnosticaccuracyofthecontrastenema Chapter 13 Appendix 2 – Extensive description of patients with a false positive enema False positive enemas, no stricture found during surgery In three patients, two treated for NEC and one for Hirschsprung disease, a stricture was seen on contrast enema whilst no strictures was observed during stoma reversal or redo-surgery making the false positive rate 13% (N=3/24) in the overall cohort and 9% (N=2/22) in patients previously treated for NEC. In one complex patient, with multiple comorbidities including cat eye syndrome and multiple congenital cardiac anomalies, Hirschsprung’s disease was suspected yet multiple full thickness biopsies could not prove this diagnosis. Before stoma reversal, a contrast enema was made in which the intestine does not fully expand at the splenic flexure which is described to be suggestive of a stricture. In the surgery report of the stoma reversal the surgeon specifically states that the contrast enema does not show any strictures or motility. The report does not describe any finding of- nor search for strictures. In the following months, after repeated full thickness biopsy, eventually Hirschsprung’s disease was proven and a Duhamel procedure was performed. The two other patients were treated for NEC. In both these patients the contrast enema before stoma reversal too showed a stricture at the splenic flexure. In the first patients the surgeons evaluated the sight indicated by the contrast enema but concluded there were no signs of strictures, no obstructive symptoms developed during follow-up. In the other patient, no comments were made on the inspection of the sight indicated by the enema. Within days this patient required redo-surgery because a suspicion of anastomotic leakage, which was not confirmed. Five months later this patient developed an adhesion ileus which required a reoperation.
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