The anomanometer: its use in the assessment of continence and in the diagnosis of Hirschsprung's disease
| Autor: | T. W. Hunt, F. Douglas Stephens, F. K. Varma |
|---|---|
| Rok vydání: | 1972 |
| Předmět: |
medicine.medical_specialty
Fistula Manometry Anorectal anomalies Transducers Anal Canal Megacolon Balloon Reflex Urethral Diseases medicine Humans Rectal Fistula In patient Child Hirschsprung's disease business.industry Urethral sphincter Infant Newborn Rectovaginal Fistula Infant General Medicine Anal canal medicine.disease Surgery medicine.anatomical_structure Child Preschool Muscle Tonus Sphincter Female business Fecal Incontinence Muscle Contraction |
| Zdroj: | The Australian and New Zealand journal of surgery. 42(2) |
| ISSN: | 0004-8682 |
| Popis: | The purpose of this paper is to describe the anomanometer, a versatile instrument, portable and easy to use. It has been used for (a) assessment of continence after surgery for anorectal malformations; and (b) the diagnosis of Hirschsprung's disease in children. The measurement of the resting and voluntary squeeze pressures provides the criteria upon which it is possible to quantify continence after surgical correction of anorectal malformations. The anomanometer records the biphasic response of the sphincters to rectal distension in normal children and the lack of the relaxation phase in Hirschsprung's disease, thus providing a convenient and simple method of diagnosis. Summary A portable anomanometer has been devised and has proved useful for the purposes of (a) assessment of continence after surgery for anorectal anomalies, and (b) the diagnosis of Hirschsprung's disease. It consists of a single air-filled tambour-type balloon mounted on a Perspex probe and connected through a transducer to an analogue readout, so that changes of pressure in the balloon induced by the sphincter muscles of the anal canal are registered as deflections of the needle of the meter. Two measurements obtained by the anomanometer provide criteria of postoperative anal sphincter function, namely the resting tone of the sphincter muscle and the voluntary squeeze pressure. Children who had had surgical reconstruction of the anal canal for supralevator, intermediate and translevator abnormalities were tested. A combination of a resting tone of 20 mm Hg with a voluntary squeeze pressure of 30 mm Hg or more was associated with an excellent state of continence, whereas the combination of a resting tone below 15 mm Hg and a voluntary squeeze less than 30 mm Hg corresponded with a clinical state of socially unacceptable incontinence. Those children with borderline resting tone of the sphincter and voluntary squeeze pressures above 30 mm Hg have varied degrees of impaired sphincter function, which may be improved in some by hardening of the faeces, education or the lapse of time. The anomanometer detected in a very reliable manner the anal responses to rectal distension, and in particular the lack of reflex relaxation of the internal sphincter in patients with Hirschsprung's disease. It proved to be a simple economical apparatus not only for the detection of Hirschsprung's disease, but also for eliminating this possibility in many patients. |
| Databáze: | OpenAIRE |
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