Tamburrini O, Bartolomeo-De Iuri A, Cucchiara S, Dolezalova H, Staiano A, Settimi A, Palescandolo P, Capocasale G, Porta E
Radiol Med. 1985 Oct;71(10):657-64.
One hundred thirteen children referred for chronic constipation were examined by means of diagnostic work-up including anal inspection, rectal exploration, weekly bowel frequency evaluation, measurement of total and segmental intestinal transit times (TITT, SITT), contrast enema, anorectal manometry (ARM), suction rectal biopsy for histochemistry. Final diagnosis were: chronic functional "simple" constipation in 53 children; chronic functional constipation and soiling in 32; Hirschsprung's disease in 18. In 10 children, initially referred for constipation, TITT was in the normal range so they underwent no further examination. Conclusions are that bowel frequency identifies a real gastrointestinal problem, but definite diagnosis of constipation is relied on TITT. In the assessment of chronic constipation nature, ARM is more sensitive than radiology. Suction rectal biopsy is reliable in detection of aganglionosis: its accuracy can be improved by histochemical or biochemical determination of Acetylcholinoesterase.
对113名因慢性便秘前来就诊的儿童进行了诊断性检查，包括肛门检查、直肠探查、每周排便频率评估、全肠道和节段性肠道转运时间（TITT、SITT）测量、灌肠造影、肛门直肠测压（ARM）、用于组织化学的直肠吸引活检。最终诊断结果为：53名儿童为慢性功能性“单纯性”便秘；32名儿童为慢性功能性便秘伴便污；18名儿童为先天性巨结肠。10名最初因便秘前来就诊的儿童，其TITT在正常范围内，因此未接受进一步检查。结论是排便频率可识别真正的胃肠道问题，但便秘的明确诊断依赖于TITT。在评估慢性便秘的性质时，ARM比放射学检查更敏感。直肠吸引活检在检测无神经节细胞症方面可靠：通过乙酰胆碱酯酶的组织化学或生化测定可提高其准确性。
