Koszutski Tomasz, Bohosiewicz Janusz, Kudela Grzegorz, Owczarek Katarzyna
Z Katedry i Kliniki Chirurgii Dzieciecej Slaskiej Akademii Medycznej w Katowicach.
Wiad Lek. 2004;57(3-4):193-6.
The chronic constipation in children can pose a big problem both in pediatric and surgical practice. The purpose of this work is to present diagnostic and treatment procedures in children with chronic constipation. For over three years 70 children with defecation problems have been referred to the Department of Pediatric Surgery in Katowice (Poland). As a result of diagnostic procedures (anorectal manometry, barium enema and rectal biopsy) Hirschsprung disease was diagnosed in 21 cases and chronic constipation in 49. Children with Hirschsprung disease were treated surgically. Children with diagnosed chronic constipation were treated conservatively (cleansing enemas, oral laxatives, diet) and good results were obtained in 30 patients. 19 children underwent anal divulsion and 16 improved. In 2 cases sphincter myotomy was performed and good result was obtained in both of them. The diagnostics and treatment of chronic constipation in pediatric surgical ward is advantageous, because: Hirschsprung disease can be excluded, cleansing of colon sometimes requires general anesthesia and in selected cases surgical procedure is necessary.
儿童慢性便秘在儿科和外科实践中都会造成大问题。本文的目的是介绍儿童慢性便秘的诊断和治疗方法。三年多来,70名有排便问题的儿童被转诊至卡托维兹(波兰)的儿科外科。通过诊断程序(肛门直肠测压、钡灌肠和直肠活检),21例被诊断为先天性巨结肠,49例为慢性便秘。先天性巨结肠患儿接受了手术治疗。诊断为慢性便秘的患儿接受了保守治疗(清洁灌肠、口服泻药、饮食调整),30例取得了良好效果。19名儿童接受了肛门扩张术,16例病情改善。2例进行了括约肌切开术,均取得了良好效果。在儿科外科病房对慢性便秘进行诊断和治疗具有优势,因为:可排除先天性巨结肠,结肠清洁有时需要全身麻醉,在某些特定情况下手术治疗是必要的。