Analysis of Children with Hirschsprung's Disease who Showed Decrease of Anal Canal Pressure

Abstract

Of 36 children with Hirschsprung's disease who were examined during past 5 years, 12 cases showed decrease of anal canal pressure on rectal distension.
In most of these, technical errors were thought to be the cause of decrease of anal canal pressure such as movement of the apparatus, overdistension of rectum and overinfusion. Finally 4 cases were not diagnosed to be Hirschsprung's disease only by anorectal manometry.
To avoid these technical errors we devised the electrical stimulation as a good method to induce recto-anal reflex. Three children who showed decrease of anal canal pressure by rectal distension did not show any decrease by electrical stimulation. Therefore, precise judgment of recto-anal reflex is necessary when anal canal pressure drops by rectal distension in the children who are suspected of Hirschsprung's disease.