All issues > Volume 34(5); 1991

Original Article

J Korean Pediatr Soc. 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

Received: October 17, 1990;  Accepted: January 8, 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.

Keywords :Congenital megacolon;Anorectal manometry