García-Valencia Oscar Alejandro, Sánchez-Ávila María Teresa, Martínez-Ordaz Lourdes, Hernández-Flores Irene, Moreno Medrano Edgar, Morales-Garza Luis Alonso, Chávez-Caraza Karla Lorena
Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud. Monterrey, Nuevo León, México.
Rev Gastroenterol Peru. 2019 Apr-Jun;39(2):136-140.
To describe the anorectal manometry results in the pediatric population with chronic constipation and acquired anorectal disease.
We reviewed the records of children who were referred to the Motility and Pelvic Floor Laboratory of the Hospital San Jose Tecnologico de Monterrey between 2004-2016 for further evaluation with anorectal manometry and who presented acquired anorectal disease.
We reviewed 170 records. The mean age was 7.18 ± 4.51 years old. The prevalence of anorectal disease was 73%. The symptoms more frequently presented were difficult evacuation (78%), painful defecation (67%), large and hard stool (50%) and fecal soiling (49%). 44% of patients with hypotonic external anal sphincter (EAS) presented with soiling and 74% of those had diminished critical volume. Significant manometric values (p<0.05) were EAS resting pressure, maximal squeeze pressure, and critical volume. 97.7% of those who underwent abdomino pelvic coordination evaluation had pelvic floor dyssynergia (anismus).
Contrary to adult population, the manometric values in children with acquire anorectal pathology were within normal values except for the EAS resting pressure and critical volume that were diminished. This could suggest a different mechanism in the pediatric population. Pelvic floor dyssynergia could explain chronic constipation in these patients.
描述患有慢性便秘和后天性肛肠疾病的儿童人群的肛肠测压结果。
我们回顾了2004年至2016年间被转诊至蒙特雷圣何塞技术医院动力与盆底实验室进行肛肠测压进一步评估且患有后天性肛肠疾病的儿童记录。
我们回顾了170份记录。平均年龄为7.18±4.51岁。肛肠疾病的患病率为73%。最常出现的症状是排便困难（78%）、排便疼痛（67%）、大便干结（50%）和大便失禁（49%）。44%的肛门外括约肌（EAS）张力减退患者出现大便失禁，其中74%的患者临界容量减小。具有显著测压值（p<0.05）的指标是EAS静息压、最大收缩压和临界容量。接受腹盆腔协调性评估的患者中，97.7%存在盆底协同失调（排便障碍）。
与成人不同，患有后天性肛肠疾病的儿童测压值除EAS静息压和临界容量减小外均在正常范围内。这可能提示儿童人群存在不同的机制。盆底协同失调可以解释这些患者的慢性便秘。
