[Neonatal diagnostic protocol of the Hirschsprung's disease].
Suction rectal biopsy (SRB) is the gold-standard for the diagnosis of Hirschsprung's disease (HD), but may not be applied before the first month of age. We propose a diagnostic protocol that allows the management of these patients.


METHODS
A retrospective analytic study is done, analysing the results of our protocol. A rectal manometry (RM) is done to any patient with clinical symptoms of HD. When first test is positive (no reflex), we practice a weekly RM till the end of the neonatal period when we propose the SRB for the confirmation of the diagnosis.


RESULTS
From 1980 to 2006 we have performed 503 tests in 391 HD's suspected neonates. Mean age in the first study was 15.19 days. In 54 cases, final diagnosis was EH. Rate of false-negative was 0.9%, sensibility 99%. Rate of non-usefull studies without sedation was 8%, being minor (2.97%) with sedation (OR = 2.853; p = 0.008).


CONCLUSIONS
The protocol with a weekly RM allows the management of these patients because of a reliable diagnosis. Sedation has two positives effects: the reduction of the time of the study and the improvement of the results.
Limousin
I Tuduri
IT
Servicio de Cirugía Pediátrica, Hospital Infantil, Hospitales Universitarios Virgen del Rocío, Sevilla.
Valdés
J A Cabo
JA
Jiménez
M J Moya
MJ
Cendón
R Granero
RG
Fernández Pineda
I
I
García
R Cabrera
RC
Alonso
M López
ML
D002985:Clinical Protocols; D006627:Hirschsprung Disease / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D012189:Retrospective Studies