Anorectal Manometry for the Exclusion of Hirschsprung's Disease in Neonates

J Pediatr Gastroenterol Nutr. 1985 Aug;4(4):596-603. doi: 10.1097/00005176-198508000-00018.

Abstract

We studied the usefulness of anorectal manometry in excluding Hirschsprung's disease in 25 neonates with signs and symptoms of intestinal obstruction. An intraluminal pressure transducer or perfused side-opening catheters were used to evaluate anal tone, anal rhythmicity, and internal sphincter relaxation during rectal distention. Hirschsprung's disease was diagnosed by rectal biopsy in 16% of the neonates. Studies using anorectal manometry gave one false positive and one false negative diagnosis of Hirschsprung's disease, which resulted in 75% sensitivity, 95% specificity, and a kappa coefficient of 0.7. We found that anorectal manometry, a rapid and atraumatic test, is a reliable screening test for exclusion of neonatal Hirschsprung's disease. By using the combination of manometry and contrast enema, it is possible to eliminate the need for a confirmatory rectal biopsy in many neonates suspected of having Hirschsprung's disease.

MeSH terms

  • Anal Canal / physiopathology*
  • Biopsy
  • Contrast Media
  • Enema
  • Female
  • Hirschsprung Disease / diagnosis*
  • Hirschsprung Disease / pathology
  • Humans
  • Infant, Newborn
  • Male
  • Manometry
  • Rectum / pathology
  • Rectum / physiopathology*
  • Reflex, Abnormal / physiopathology
  • Transducers, Pressure

Substances

  • Contrast Media