Hirschsprung 씨 질환에서 항문직장계측검사의 진단적 의의

Abstract

It is well known that stimulation of rectum by balloon distention results in the reflex relaxation of the internal anal sphincter in the normally innervated bowel. and this rectosphincteric reflex is absent in Hirschsprung's disease. It's the first report in Korea to evaluate diagnostic reliability of anorectal pressure study in Hirschsprung's disease using anorectal manometry, Model 003 developed by professor Holschneider. This investigation was performed on 21 consecutive children who complained of acute intestinal obstruction especially in infants and chronic constipation during the period February 1986 to September 1987. The ages of the children ranged from 8 days to 15 years, and 8 patients including the 4 neonates were examined within 1 year old. The 7 patients were proved to have Hirschsprung's disease who revealed no rectosphincteric reflex on anorectal pressure study, and Hirschsprung's disease was ruled out in 14 patients who reveales rectosphincteric reflex. In 2 out of 14 patients who showed no rectosphincteric reflex, Hirschsprung's disease was ruled out by rectal suction biopsy and clinical course. With the above results, this study shows an over-all diagnostic accuracy 90% along with sensitivity 100% and specificity 86%. In conclusion, anorectal pressure study is a reliable, diagnostic procedure for Hirschsprung's disease, and it has the advantage of simple , non-invasive and safe procedure without general anesthesia and is of particular value as a screening test in inpatients as well as outpatients.