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Accuracy of anorectal manometry in the diagnosis of congenital megacolon.

Journal of the Korean Pediatric Society 1991;34(5):614-620.
Published online May 31, 1991.
Accuracy of anorectal manometry in the diagnosis of congenital megacolon.
Jong Yul Jeon1, Byeong Gie Yeo1, Chong Woo Bae1, Yong Mook Choi1, Chang Il Ahn1, Young Woon Chang2
1Department of Pediatrics, College of Medicine, Kyung Hee University, Seoul, Korea
2Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
선천성 거대결장에서 항문직장내압 측정검사의 진단적 의의
전종율1, 여병기1, 배종우1, 최용묵1, 안창일1, 장영운2
1경희대학교 의과대학 소아과학교실
2경희대학교 의과대학 내과학교실
Received: 17 October 1990   • Accepted: 8 January 1991
Abstract
Thirty-seven patients with clinical impression of congenital megacolon were studied with anorectal manometry for the evaluation of its diagnostic accuracy. Including 12 neonates, their age ranged form 3 days to 8 years and barium enema was performed to all of them except one. The results of rectosphincteric reflex (RSR) of anorectal manometry was compared with the final diagnosis, which was obtained by clinical course, barium enema and/or rectal biopsy. 1) Among 22 cases who were proved to be having no congenital megacolon, 2 cases failed to show RSR. This means there were 2 cases of false positive diagnosis. 2) As RSR was not obtatined from anyone of 15 cases who were proved to have congential megacolon, there were no cases of false negative diagnosis. 3) Overall, a 94.6% diagnostic accuracy was achieved with anorectal manometry along with 100% sensitivity and 90.9% specificity. 4) The diagnostic accuracy of barium enema, which was perfromed to all except one, was 91.7%. 5) In 18 cases, both the anorectal manometry and barium enema diagnsoed as normal and they were all confirmed to have no congenital megacolon. 6) During and after the procedure, we could not find any complications or side reactions. In conclusion, anorectal manometry as a rapid and non-invasive diagnostic method can be a reliable screening test for the exclusion of congenital megacolon. By using the combination of anorectal manometry and barium enema, it will be possible to eliminate the need for the confirmatory rectal biopsy.
Key Words: Congenital megacolon, Anorectal manometry


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