Combined method for the diagnosis of Hirschsprung's disease

Forty children between the ages of 10 days to 10 years were examined over the course of a year because of constipation and suspicion of Hirschsprung's disease. The work-up included clinical examination, barium enema, manometric study of the internal anal sphincter and mucosal and submucosal rectal biopsy. 10 children were diganosed as suffering from Hirschprung's disease. The remaining 30 children were shown to have idiopathic megacolon. In only one case was it necessary to perform a full-thickness rectal biopsy under general anesthesia. In three cases of Hirschsprung's disease the manometric study showed a normal pattern. Histological examination of rectal mucosal and submucosal biopsy in 39 children proved reliable in all cases. The combination of barium enema, manometric study and superficial rectal biopsy enables precise and quick diagnosis of Hirschsprung's disease.