ANAL TONOMETRY A Diagnostic Help in Hirschsprung's Disease1

Manometrical measurements of reflex responses in the internal anal sphincter were made in 93 patients. In normal controls, a relaxation was obtained within the internal sphincter after distension of the rectum. Patients suffering from Hirschsprung's disease showed either a contraction in the muscle or an absence of sphincteric response. In 17 cases, where the diagnosis of Hirschsprung's disease was established by conventional means, the diagnosis was confirmed by anal tonometry in 13 cases and disproved by this method in 4 cases. The subsequent clinical course and histological findings have verified the diagnosis obtained by tonometry. In one patient it was not possible to make the diagnosis by means of the usual methods, anal tonometry showed Hirschsprung's disease and this was subsequently confirmed by biopsy.