Hirschsprung 씨 질환에서 항문직장계측검사의 진단적 의의
- Hirschsprung 씨 질환에서 항문직장계측검사의 진단적 의의
- Other Titles
- Diagnostic Efficacy of Anorectal Manometry in Hirschsprung's Disease
- 박우현; 최순옥; 강중신; 백태원
- Issue Date
- Keimyung University School of Medicine
- Keimyung Medical Journal, Vol.6(2) : 307~313, 1987
- 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 12 out of 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.; 저자들은 최근에 Holschneider 교수에 의해 개발되어 Martin Gruber회사서 제조된 ARM Model003을 이용하여; HD또는 HD와 감별이 요하는 환아 21예에 응용하여 민감도 100% 특이도 86% 정확도 90%로 HD의 감별전단에 유용함을 확인하였다. 특히 대장조영술로 진단이 어려운 신생아 HD; 최단부위침범형 HD; 전대장무신경절형 HD; 이미 경장조루술을 받은 환아등에서 ARM가 진단적 가치가 높을 것으로 사료된다.
ARM는 비침습적(non-invasive) 진단방법이고; 전신마취없이 외래서 간단히 할 수 있으므로 Hd가 의심되는 모든 환아에서 하나의 선별검사(screening test)로서 널리 이용되어지기를 바라는 바이다.
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