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Korean J Pediatr Gastroenterol Nutr. 2003 Mar;6(1):24-31. Korean.
Published online Mar 31, 2003.  https://doi.org/10.5223/kjpgn.2003.6.1.24
Copyright © 2003 The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
Diagnostic Efficacy of Anorectal Manometry for the Diagnosis of Hirschsprung's Disease
Soo Hee Chang, Uoo Gyung Min, Ok Ja Choi, Dae Yeon Kim,* Seong Chul Kim,* Chang Sik Yu,* Jin Cheon Kim,* In Koo Kim,* Jong Hyun Yoon, and Kyung Mo Kim
Department of Pediatrics, Seoul Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
*Department of Surgery, Seoul Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Radiology, Seoul Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Abstract

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.

Keywords: Hirschsprung's disease; Anorectal manometry; Barium enema