Abstract
Anorectal manometric studies, histochemicsl examinations, and measurement of erythrocyte acetyl-cholinesterase (AchE) and serum cholinesterase (ChE) activities were carried out in 11 patients of Hirschsprung's disease, comparing with those in 25 normal subjects. Anorectal reflex was absent and AchE positive nerve fibers of the rectal mucosa were observed in all 11 patients with Hirschsprung's disease. Erythrocyte AchE Activity in patients of Hirschsprung' disease was significantly higher (p<0.01) than in normal subjects. On the other hand, serum ChE activity in Hirschsprung's disease patients was higher than in normal subjects, but there was no statistical significance (0.05<p<0.1). These results suggest that anorectal manometric study, histochemical examination, and an assay of erythrocyte AchE activity are all reliable for the diagnosis of Hirschsprung's disease. Anorectal manometric study should be performed at first as a simple screening test for the diagnosis of Hirschsprung's disease. Barium enema and histochemical examination of the rectal wall are performed next and then erythrocyte AchE & serum ChE are measured in the case of an absence of reflex relaxation or an inadequate response of the sphincter to rectal distension.
