Diagnostic significance of defecoscopy in children with anal achalasia
PEDIATRIC SURGERY
Abstract
Introduction.It is believed that the most visually characterizing the processes occurring in the anal canal during defecation are the study of the rectoanal inhibitory reflex and defecoscopy. The degree of correlation of such an indicator of defecoscopy as the opening of the anal canal with the rectoanal inhibitory reflex has not yet been established, although, in fact, this is a study of a single process.The aimof the study was to establish the degree of correlation between the opening of the anal canal during defecoscopy and the rectoanal inhibitory reflex in children with anal achalasia.Materials and methods.We observed 78patients with anal achalasia. The patients ranged in age from four to seventeen years old. The inclusion criterion was as follows: children with anal achalasia. All children underwent an examination, which included irrigation with barium, defecoscopy and a study of the rectoanal inhibitory reflex. Statistical processing of the obtained results was carried out using the Statistica for Windows, 2007 package.Results.In all patients of the first group, the anal canal did not open during defecoscopy and the rectoanal inhibitory reflex was negative. In all patients of the second group, the anal canal opened during defecoscopy and the rectoanal inhibitory reflex was positive. The opening of the anal canal during defecoscopy in both study groups had a direct and strong correlation with the rectoanal inhibitory reflex.Discussion.Isolated works are devoted to the correlation of various methods of research of the anorectal zone. However, not all authors acknowledge the existence of anal achalasia without providing strong arguments to support their findings. The completed work confirms the above and is the only work devoted to this problem in childhood.Conclusion.In anal achalasia in children, the defecoscopy indicator — the opening of the anal canal — in all cases has a direct and strong correlation with the indicators of the rectoanal inhibitory reflex. Since the study of the opening of the anal canal is available to any medical institution with an X-ray machine, it can be used as a screening for chronic constipation.
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