title: Anorectal manometry for the exclusion of Hirschsprung's disease in neonates.
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: D001003:Anal Canal / Q000503:physiopathology*; D001706:Biopsy; D003287:Contrast Media; D004733:Enema; D005260:Female; D006627:Hirschsprung Disease / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008365:Manometry; D012007:Rectum / Q000473:pathology / Q000503:physiopathology*; D012021:Reflex, Abnormal / Q000503:physiopathology; D014160:Transducers, Pressure
chemical_list: D003287:Contrast Media