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Volume 23 |
October - December 2007 (Part-I) |
Number 5 |
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Published by : PROFESSIONAL MEDICAL PUBLICATIONS |
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Volume 23 |
October - December 2007 (Part-I) |
Number 5 |
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Role of anorectal manometry to improve the results
of biopsy in diagnosis of chronic constipation
Ali-Akbar Sayyari1, Farid Imanzadeh2,
Javad Ghoroubi3,
Hazhir Javaherizadeh4, Ehsan Hendabadi5
ABSTRACT
Objective: Most pediatric constipation cases may be treated with an adequate diet and moderate use of laxatives and enemas. A significant proportion of patients, however, does not show improvement with these therapeutic measures. In these cases, it is necessary to establish the differential diagnosis between functional and structural constipation. The objective of this study was to compare the result of two methods of evaluation, manometry before biopsy and biopsy alone.
Methodology: This cross sectional study was carried out in the children with chronic constipation that were referred to Mofid Children Hospital and underwent rectal manometry from 2002-2006. Chi-square test was used for the analysis.
Results: From 347 patients who underwent anorectal manometry, 134 patients had evidence that indicated neurologic abnormality and hirschprung disease. From these patients, based on parental agreement, biopsy were obtained from 69 patients. Histopathologic study was performed on 69 samples, and 57(82.6%) specimens had evidence of neuroanatomic abnormality as a cause of the disease. From the 423 biopsy that were obtained from rectal wall without previous anortectal manometry, only 125(29.55%) patients had pathological evidence of structural abnormalities due to Hirschprung disease. From all the biopsy (480), only 57(11.87%) patients had anorectal manometry. Based on there results of anorectal manometry they underwent biopsy.
Conclusion: Performing anorectal manometry as a first step to approach constipation could increase specifity of biopsy in contrast to performing biopsy without anorectal manometry. Due to some limitation, we did not obtain biopsy from patients whose manometry was normal.
KEYWORDS: Anorectal manometry, Hirschprung’s disease, Constipation.
Pak J Med Sci October - December 2007 (Part-I) Vol. 23 No. 5 689-691
1. Dr. Ali-Akbar Sayyari,
Prof. of Peditaric Gastroenterology,
2. Dr. Farid Imanzadeh,
Assistant Prof. of Peditaric Gastroenterology,
3. Dr. Javad Ghoroubi,
Assistant Prof. of Peditaric Surgery,
4. Dr. Hazhir Javaherizadeh,
Resident of Pediatrics,
5. Dr. Ehsan Hendabadi,
General Practitioner,
1-5: Mofid Children Hospital,
Shahid Beheshti University of Medical Sciences
Tehran – Iran.
Correspondence
Hazhir Javaherizadeh,
Email: hazhirja@yahoo.com
* Received for Publication: April 14, 2007
* Revision Received: June 19, 2007
* Revision Accepted: July 2, 2007
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