Sensitivity and Specificity of Anorectal Manometry in the Differential Diagnosis of Chronic Constipation in Children

BACKGROUND AND OBJECTIVE: Constipation is one of the most common reasons a child is referred to a pediatric gastroenterologist. In the vast majority no structural, endocrine, or metabolic etiology is identified and constipation called functional or idiopathic. The aim of this study was to evaluate t...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	F Farahmand, M . Najafi, GH.R Khatami, GH.H Fallahi, A Khodadad, F Mahjob, F Moetamed, F Yourdkhani
Formato:	article
Lenguaje:	EN FA
Publicado:	Babol University of Medical Sciences 2010
Materias:	children constipation hirschprung’s disease Medicine R Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/9c2a2cfdd1e74af9be41072290551b33
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:9c2a2cfdd1e74af9be41072290551b33
record_format	dspace
spelling	oai:doaj.org-article:9c2a2cfdd1e74af9be41072290551b332021-11-10T09:00:22ZSensitivity and Specificity of Anorectal Manometry in the Differential Diagnosis of Chronic Constipation in Children1561-41072251-7170https://doaj.org/article/9c2a2cfdd1e74af9be41072290551b332010-06-01T00:00:00Zhttp://jbums.org/article-1-3526-en.htmlhttps://doaj.org/toc/1561-4107https://doaj.org/toc/2251-7170BACKGROUND AND OBJECTIVE: Constipation is one of the most common reasons a child is referred to a pediatric gastroenterologist. In the vast majority no structural, endocrine, or metabolic etiology is identified and constipation called functional or idiopathic. The aim of this study was to evaluate the role of anorectal monometry in differentiating functional constipation from Hirschprung’s disease in children.METHODS: This cross sectional study was performed on 69 children aged 6 months– 13 years with chronic constipation, who didn’t response after suitable therapy during one year in children’s Hospital Medical Center. All of children underwent un-prepared contrast enema, considering: transition-zone, retained contrast after 24hr and abnormality of rectal diameter. Rectal biopsy was performed in patients with negative RAIR and suspected to hirschsprung’s disease, and data was analyzed. FINDINGS: Sixty nine children with age range 6 months- 13 years (mean age of 53.1±14 months) including 37 girls (53.62%) and 32 boys (46.38%) were studied. Rectoanal inhibitory reflex (RAIR) was present in 54 of the 69 patients (78.26%), and 15 cases (21.73%) with a negative (RAIR), underwent rectal biopsy. In which showed absence of the ganglion cells and intestinal neuronal dysplasia in 13 cases, that was compatible with Hirschsprung’s disease. Rectal manometry was again performed for 2 remained patients who had shown to have normal ganglion cell in their last rectal biopsy, and normal RIAR was determined. Sensitivity, specificity, positive and negative predictive value of the manometric test for diagnosis of Hirschprung’s diseases were 100%, 96%, 88% and 100%, respectively. CONCLUSION: The results of this study showed that anorectal manometry is the suitable method for diagnosis of functional constipation from Hirschprung’s disease in children. Rectal manometry is recommended before rectal biopsy for all children with refractory chronic constipation who are suspected to have Hirschsprung’s disease.F Farahmand,M . NajafiGH.R Khatami,GH.H FallahiA Khodadad,F Mahjob,F Moetamed,F YourdkhaniBabol University of Medical Sciencesarticlechildrenconstipationhirschprung’s diseaseMedicineRMedicine (General)R5-920ENFAMajallah-i Dānishgāh-i ̒Ulūm-i Pizishkī-i Bābul, Vol 12, Iss 2, Pp 47-52 (2010)
institution	DOAJ
collection	DOAJ
language	EN FA
topic	children constipation hirschprung’s disease Medicine R Medicine (General) R5-920
spellingShingle	children constipation hirschprung’s disease Medicine R Medicine (General) R5-920 F Farahmand, M . Najafi GH.R Khatami, GH.H Fallahi A Khodadad, F Mahjob, F Moetamed, F Yourdkhani Sensitivity and Specificity of Anorectal Manometry in the Differential Diagnosis of Chronic Constipation in Children
description	BACKGROUND AND OBJECTIVE: Constipation is one of the most common reasons a child is referred to a pediatric gastroenterologist. In the vast majority no structural, endocrine, or metabolic etiology is identified and constipation called functional or idiopathic. The aim of this study was to evaluate the role of anorectal monometry in differentiating functional constipation from Hirschprung’s disease in children.METHODS: This cross sectional study was performed on 69 children aged 6 months– 13 years with chronic constipation, who didn’t response after suitable therapy during one year in children’s Hospital Medical Center. All of children underwent un-prepared contrast enema, considering: transition-zone, retained contrast after 24hr and abnormality of rectal diameter. Rectal biopsy was performed in patients with negative RAIR and suspected to hirschsprung’s disease, and data was analyzed. FINDINGS: Sixty nine children with age range 6 months- 13 years (mean age of 53.1±14 months) including 37 girls (53.62%) and 32 boys (46.38%) were studied. Rectoanal inhibitory reflex (RAIR) was present in 54 of the 69 patients (78.26%), and 15 cases (21.73%) with a negative (RAIR), underwent rectal biopsy. In which showed absence of the ganglion cells and intestinal neuronal dysplasia in 13 cases, that was compatible with Hirschsprung’s disease. Rectal manometry was again performed for 2 remained patients who had shown to have normal ganglion cell in their last rectal biopsy, and normal RIAR was determined. Sensitivity, specificity, positive and negative predictive value of the manometric test for diagnosis of Hirschprung’s diseases were 100%, 96%, 88% and 100%, respectively. CONCLUSION: The results of this study showed that anorectal manometry is the suitable method for diagnosis of functional constipation from Hirschprung’s disease in children. Rectal manometry is recommended before rectal biopsy for all children with refractory chronic constipation who are suspected to have Hirschsprung’s disease.
format	article
author	F Farahmand, M . Najafi GH.R Khatami, GH.H Fallahi A Khodadad, F Mahjob, F Moetamed, F Yourdkhani
author_facet	F Farahmand, M . Najafi GH.R Khatami, GH.H Fallahi A Khodadad, F Mahjob, F Moetamed, F Yourdkhani
author_sort	F Farahmand,
title	Sensitivity and Specificity of Anorectal Manometry in the Differential Diagnosis of Chronic Constipation in Children
title_short	Sensitivity and Specificity of Anorectal Manometry in the Differential Diagnosis of Chronic Constipation in Children
title_full	Sensitivity and Specificity of Anorectal Manometry in the Differential Diagnosis of Chronic Constipation in Children
title_fullStr	Sensitivity and Specificity of Anorectal Manometry in the Differential Diagnosis of Chronic Constipation in Children
title_full_unstemmed	Sensitivity and Specificity of Anorectal Manometry in the Differential Diagnosis of Chronic Constipation in Children
title_sort	sensitivity and specificity of anorectal manometry in the differential diagnosis of chronic constipation in children
publisher	Babol University of Medical Sciences
publishDate	2010
url	https://doaj.org/article/9c2a2cfdd1e74af9be41072290551b33
work_keys_str_mv	AT ffarahmand sensitivityandspecificityofanorectalmanometryinthedifferentialdiagnosisofchronicconstipationinchildren AT mnajafi sensitivityandspecificityofanorectalmanometryinthedifferentialdiagnosisofchronicconstipationinchildren AT ghrkhatami sensitivityandspecificityofanorectalmanometryinthedifferentialdiagnosisofchronicconstipationinchildren AT ghhfallahi sensitivityandspecificityofanorectalmanometryinthedifferentialdiagnosisofchronicconstipationinchildren AT akhodadad sensitivityandspecificityofanorectalmanometryinthedifferentialdiagnosisofchronicconstipationinchildren AT fmahjob sensitivityandspecificityofanorectalmanometryinthedifferentialdiagnosisofchronicconstipationinchildren AT fmoetamed sensitivityandspecificityofanorectalmanometryinthedifferentialdiagnosisofchronicconstipationinchildren AT fyourdkhani sensitivityandspecificityofanorectalmanometryinthedifferentialdiagnosisofchronicconstipationinchildren
_version_	1718440311543300096

Sensitivity and Specificity of Anorectal Manometry in the Differential Diagnosis of Chronic Constipation in Children

Ejemplares similares