Manometric studies of anorectal disorders in infancy and childhood: An investigation of the physiopathology of continence and defaecation

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Abstract
Anorectal manometry was performed on 126 infants and children with anorectal disorders. In addition, 14 normal children were studied. Pressure measurements were taken with two perfused open-tip catheters. The activity of the external and internal sphincters of the anus was also assessed. A latex balloon was used to distend the rectal ampulla with air. The following factors were particularly studied: The value of the basal pressure in the anal canal, which provides an estimation of sphincteric competence. The presence or absence of rectal internal sphincteric relaxation and rectal external sphincteric contraction, which are altered in certain neurological defects. The rectal sensitivity, which initiates the urge to defaecate. All the diseases which affect continence and defaecation justify a manometric investigation. The results obtained in Hirschsprung's disease, idiopathic constipation, anal malformations and spina bifda are reported and discussed. The main interest of the manometric technique lies in the diagnosis of congenital megacolon, but constipation and the little investigated fields of anal imperforation and spina bifida are likely to be of great interest in future manometric studies.