Anorectal manometry during the neonatal period: Its specificity in the diagnosis of Hirschsprung's disease

In this study the reliability of anorectal manometry (ARMM) in Hirschsprung 's disease (HD) in the neonatal period is evaluated. ARMM was performed in 59 patients (age ranging between 2 to 90 days) in whom HD was suspected. Re ctal biopsy was performed in 23 newborn whose rectoanal inhibitory reflex ( RAIR) was not identified in the ARMM study and in 13 RAIR-positive newborn due to strong clinical signs supporting HD or persistence of symptoms durin g their follow-up. Other RAIR-positive patients were followed up to 4 month s to 3.5 years and no problems were encountered. Among the 36 newborn with rectal biopsies, if the results were compared to ARMM studies, there were o ne false-positive and two false-negative results. The sensitivity, specific ity, positive predictive value, negative predictive value and accuracy of A RMM in the diagnosis of HD are 91.6 %, 95.6 %, 84.6 % and 91.6 % respective ly. We conclude that ARMM can be used as a screening test in patients in wh om HD is suspected during the neonatal period, but for definitive diagnosis it must be combined with other diagnostic tests.