[The value and reliability of ano-rectal electromanometry (author's transl)]

2,043 anorectal pressure measurements were performed at our hospital during the past 8 years. A majority of the studies, 1,595 measurements (78.1%), involved the differential diagnosis of chronic constipation. The validity of the electromanometry was analyzed on the basis of 332 patients with chronic constipation who were examined during the past 2 years. The electromanometric diagnostic failure rate was 17.6% in newborns up to 4 weeks of age, whereby false negative results predominated, at 11.7%. The diagnostic failure rate subsequently diminished rapidly, and was only 3.4% in the 1-6 month age group 0.6% in children over the age of 5. The overall figure was 1.5%. Among 91 patients with Hirschsprung's disease, a false electromanometric diagnosis was made in 18.5% of cases in the 0-31-day age group. Here too, the diagnostic failure rate decreased with increasing age of the children, to up to 9.5% (1-6 months) and 5.5% (over 5). The overall diagnostic failure rate was 8.7%. When compared with other methods of diagnosing Hirschsprung's disease, however, X-ray studies proved to be no better, with 25.9% false diagnoses in the 1-31-day-olds and an overall failure rate of 16.3%. The histologic diagnosis of Hirschsprung's disease fared the worst: faulty ganglion cell evaluations were made in 29.6% of cases in the 0-31-day age group. The overall diagnostic failure rate here was 16.3%. Acetylcholinesterase staining provided the most favorable results, with 13.3% false diagnoses in 0-4-week-olds and an overall diagnostic failure rate of 10.4%.