MANOMETRY, PROFILOMETRY, AND ENDOSONOGRAPHY - NORMAL PHYSIOLOGY AND ANATOMY OF THE ANAL-CANAL IN HEALTHY-CHILDREN

Normal anal manometric and profilometric values and normal endosonogra phic features of the anal canal are required for evaluation of patholo gical conditions such as slow-transit constipation, anorectal outlet o bstruction, and Hirschsprung's disease, status after surgery for imper forate anus, and other anal abnormalities. Anorectal manometry, profil ometry (rapid-pull-through, three-dimensional, eight-channel radial ma nometry), and endosonography were carried out in 13 healthy children. A significant correlation was demonstrated between conventional manome tric and profilometric maximal squeeze pressure of the external anal s phincter (EAS). However, the maximal anal resting tone of the sphincte r complex in profilometry was twice as high as in manometry due to ref lexive contraction of a pelvic floor muscle, probably the EAS. With pr ofilometry a positive correlation was found between age and sphincter length. Endosonographically assessed thickness of the EAS, puborectal muscle, and levator ani complex showed a significant correlation with age. However, no correlation was demonstrated between age and internal anal sphincter thickness. Thus, the development of the essential stru ctures of the anal canal in children is age dependent. In addition, th ese measurements of normal physiology and anatomy of the anal canal pr ovide the basis for detecting pathological conditions the anorectal re gion in children.