title: Anorectal manometry during the neonatal period: its specificity in the diagnosis of Hirschsprung's disease.
abstract: In this study the reliability of anorectal manometry (ARMM) in Hirschsprung's disease (HD) in the neonatal period is evaluated. ARMM was performed in 59 patients (age ranging between 2 to 90 days) in whom HD was suspected. Rectal biopsy was performed in 23 newborn whose rectoanal inhibitory reflex (RAIR) was not identified in the ARMM study and in 13 RAIR-positive newborn due to strong clinical signs supporting HD or persistence of symptoms during their follow-up. Other RAIR-positive patients were followed up to 4 months to 3.5 years and no problems were encountered. Among the 36 newborn with rectal biopsies, if the results were compared to ARMM studies, there were one false-positive and two false-negative results. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ARMM in the diagnosis of HD are 91.6%, 95.6%, 84.6% and 91.6% respectively. We conclude that ARMM can be used as a screening test in patients in whom HD is suspected during the neonatal period, but for definitive diagnosis it must be combined with other diagnostic tests.
authors.affiliation: Department of Pediatric Surgery, Cerrahpaşa Medical Faculty, University of Istanbul, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Emir
authors.forename: M
authors.initials: M
authors.lastname: Akman
authors.forename: N
authors.initials: N
authors.lastname: Sarimurat
authors.forename: N
authors.initials: N
authors.lastname: Kiliç
authors.forename: E
authors.initials: E
authors.lastname: Erdoğan
authors.forename: Y
authors.initials: Y
authors.lastname: Söylet
mesh_terms: D001003:Anal Canal / Q000503:physiopathology*; D005260:Female; D006627:Hirschsprung Disease / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008365:Manometry / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D012007:Rectum / Q000503:physiopathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity