Awad R, Camelo A L, Decanini C, Andraca R
Unidad de Medicina Experimental, Hospital General de México de la Secretaría de Salud, México D.F.
Acta Gastroenterol Latinoam. 1994;25(5):277-80.
In children, damage in the anal area which affects both the external anal sphincter and the internal anal sphincter is serious problem. Biofeedback is not effective if the external anal sphincter is severely damaged, and surgery by itself cannot effect a cure for incontinence in these cases.
a girl aged 6 yrs 8 months who from the age of two suffered from massive recurrent tricolephalosis, causing rectal prolapse, anal abscesses and fistulas, fistulectomy, and finally severe damage in the anal area with total incontinence. The treatment began with recto-anal manometry, and rectal sensitivity studies. Biofeedback was used before and after gracilis muscle transfer and colostomy. After 12 months, total continence was achieved, and has continued through 7 years of follow-up examinations.
To treat fecal incontinence combined with severe damage in the external anal sphincter, the following procedure should be followed: manometry and sensitivity studies, reconstruction of the external anal sphincter with gracilis muscle transfer, and biofeedback.
在儿童中，肛门区域同时影响肛门外括约肌和肛门内括约肌的损伤是一个严重问题。如果肛门外括约肌严重受损，生物反馈疗法无效，并且在这些情况下仅靠手术本身无法治愈大小便失禁。
一名6岁8个月的女孩，从两岁起就患有大量复发性鞭虫病，导致直肠脱垂、肛门脓肿和肛瘘，接受了瘘管切除术，最终肛门区域严重受损，完全失禁。治疗始于直肠肛门测压和直肠敏感性研究。在股薄肌转移和结肠造口术前后均使用了生物反馈疗法。12个月后，实现了完全自控，并且在7年的随访检查中一直保持。
要治疗合并肛门外括约肌严重损伤的大便失禁，应遵循以下程序：测压和敏感性研究、通过股薄肌转移重建肛门外括约肌以及生物反馈疗法。
