High‐resolution anorectal manometry in newborns: normative values and diagnostic utility in Hirschsprung disease

• Published in: Neurogastroenterology and motility 2014-11, Vol.26 (11), p.1565-1572
• Main Authors: Tang, Y.‐F., Chen, J.‐G., An, H.‐J., Jin, P., Yang, L., Dai, Z.‐F., Huang, L.‐M., Yu, J.‐W., Yang, X.‐Y., Fan, R.‐Y., Li, S.‐J., Han, Y., Wang, J.‐H., Gyawali, C. P., Sheng, J.‐Q.
• Format: Article
• Language: English
• Subjects: Anal Canal - anatomy & histology; Anal Canal - physiology; Female; high‐resolution anorectal manometry; Hirschsprung disease; Hirschsprung Disease - diagnosis; Humans; Infant, Newborn; Male; Manometry - methods; newborns; Reference Values
• ISSN: 1350-1925; 1365-2982
• DOI: 10.1111/nmo.12423

Background Conventional methods of screening for Hirschsprung disease (HD) in newborns (barium enema, BE; anorectal manometry, ARM; rectal suction biopsy, RSB) have limitations and/or are invasive. High‐resolution anorectal manometry (HR‐ARM) is a minimally invasive technique that has potential to overcome most of these limitations, but normative data and performance characteristics have not been reported in newborns. The aims of our study were to assess anorectal sphincter metrics including resting pressure (RP), anal canal length (ACL), and rectoanal inhibitory reflex (RAIR) in healthy and asymptomatic newborns, and to explore the role of HR‐ARM in the diagnosis of HD using these normal parameters. Methods All procedures were performed using solid state HR‐ARM equipment (Medical Measurement Systems, Enchede, The Netherland) by a single operator. In the first phase, 180 asymptomatic newborns (term newborns 95, preterm newborns 85) were studied, and anal RP, ACL, and RAIR were measured. In the second phase, 16 newborns with clinical manifestations of HD were studied (9 of whom had histopathologic confirmation), and parameters compared to asymptomatic newborns. Key Results Normative RP values were higher in term newborns compared with preterm newborns (p