Campobasso P, Belloli G
Divisione di Chirurgia Pediatrica, Ospedale Regionale di Vicenza, Italia.
Pediatr Med Chir. 1988 May-Jun;10(3):241-50.
Chronic constipation in childhood, with or without megarectum, with or without encopresis is a symptom of many diseases. In the majority of this patients a detailed history and an accurate physical examination differentiate functional and aganglionic constipations by other causes of constipations. Anorectal manometry is an excellent diagnostic technique for diagnosis of ultrashort segment Hirschsprung's disease. The rectoanal inhibitory reflex is present in severe chronic functional constipations and absent in aganglionic constipations. Anorectal manometry is a simple and perfectly harmless technique. The possibility of error is very small in patients aged over two years. Surgical treatment is recommended in ultrashort segment Hirschsprung's disease. Medical treatment is recommended in chronic functional constipation and after surgical treatment. It is very important that the period of treatment is long enough to avoid relapses.