Usefullness of Recto-anal Inhibitory Reflex in the Diagnosis of Hirschsprung Disease in Infancy / 대한소화관운동학회지

ABSTRACT

BACKGROUND/AIMS: It is difficult to clinically distinguish infants with Hirschsprung disease (HD) from those with other causes of intestinal obstruction. Therefore, reliable and safe diagnostic procedures are particularly necessary in infants with early onset symptoms. The purpose of this study was to assess the accuracy of anorectal manometry in the diagnosis of HD in infancy. METHODS: Forty five infants who were suspected of having HD, at Seoul National University Children's Hospital, from May 1999 to July 2002, were enrolled in this study. The diagnostic accuracy of recto-anal inhibitory reflex (RAIR) and transition zone was evaluated. RESULTS: Final diagnosis of HD was made in 18 cases. The presence of transition zone was proved to be very specific (100%), but sensitivity was very low (39%). The sensitivity and specificity of anorectal manometry were 100% and 93% in total 45 infants. However the sensitivity and specificity of this test were 100% in infants older than 3 months. CONCLUSIONS: It could be stated that the diagnostic accuracy of the RAIR is a highly valid diagnostic value for HD in young infancy. It is particularly helpful when clinical and radiological findings are inconclusive.