Korean J Pediatr Gastroenterol Nutr.
2003 Mar;6(1):24-31.
Diagnostic Efficacy of Anorectal Manometry for the Diagnosis of Hirschsprung's Disease
- Affiliations
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- 1Department of Pediatrics, Seoul Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. kmkim@amc.seoul.kr
- 2Department of Surgery, Seoul Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- 3Department of Radiology, Seoul Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Abstract
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PURPOSE: As diagnostic tools for Hirschsprung's disease (HD), barium enema and rectal biopsy have radiation exposure and invasiveness respectively; however anorectal manometry does not have these disadvantages. We therefore performed this study to evaluate the diagnostic efficacy of anorectal manometry.
METHODS
We reviewed medical records of infants with one or two symptoms of vomiting, abdominal distension, chronic diarrhea or constipation who had a anorectal manometry followed by barium enema and/or biopsy from July 1995 to May 2002. We evaluated the sensitivity, specificity and predictive value of anorectal manometry and barium enema for diagnosis of HD. We also measured sphincter length, median value of balloon volume at which rectoanal inhibitory reflex (RAIR) occurred.
RESULTS
All 61 patients received anorectal manometry, 33 of 61 received barium enema. 18 of 61 were diagnosed as HD according to histology and 43 of 61 were evaluated as a control. The sensitivity, specificity, positive predictive value, negative predictive value of anorectal manometry and barium enema for diagnosis of HD were 1.00, 0.91, 0.82, 1.00 and 0.93, 0.67, 0.70, 0.92 respectively. The mean value of sphincter length in control was 1.68+/-0.67 cm and correlated with age, weight and significantly longitudinal length. The median value of balloon volume at which RAIR occurred was 10 mL and did not correlated with age, weight and longitudinal length.
CONCLUSION
This study suggests that anorectal manometry is an excellent initial screening test for Hirschsprung's disease because of its safety and accuracy.
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