The diagnostic value of anorectal manometry as a screening test for Hirschsprung's disease

The diagnostic accuracy of anorectal manometry as a screening test for Hirschsprung's disease (HD) was assessed in 46 children suspected of having HD on clinical grounds. Among 33 children in whom a rectosphincteric reflex (RSR) was not demonstrated on manometric recordings, 31 were later proven to have HD by full thickness rectal biopsy: the remaining 2 children were shown not to have HD. None of the 12 children who had a normal RSR had HD. Thus, two false positive diagnoses were observed in this study, giving an overall diagnostic accuracy by anorectal manometry of 95 per cent and diagnostic sensitivity of 100 per cent. Anorectal manometry is an accurate, non-invasive test which has a place as the screening test of choice for HD.