[Antegrade colonic enemas for intractable constipation in non-mentally retarded children]. 2009

J Blasco Alonso, and C Sierra Salinas, and V M Navas López, and R Gil Gómez, and A Barco Gálvez, and A Unda Freire, and J Gaztambide Casellas, and C Miguélez Lago
Unidad de Gastroenterología, Hepatología y Nutrición Infantil, Hospital Materno-Infantil, Hospital Regional Universitario Carlos Haya, Málaga, España. javierblascoalonso@yahoo.es

A descriptive review of 12 patients who underwent appendicocecostomy or caecostomy for antegrade colonic lavage from January 2002 to February 2008. There were 9 appendicocecostomies performed patients from 3 to 13 years suffering from myelomeningocele, of which 8 of them had a very good outcome, with one case withdrawn due to poor use by the family. Three caecostomies were performed in non-mentally retarded constipated children. One was an otherwise healthy 7 year-old boy with hard stools since he was 10 months old, in spite of multiple laxative treatments, with normal morphology and function. He had a percutaneous caecostomy five years ago, with some improvement and a good quality of life, but still some occasional partial impactions. Another healthy 12 year-old boy with daily constipation associated faecal incontinence since he was 3 years old (normal manometry and rectal biopsy with signs of mild neuronal dysplasia) had a percutaneous caecostomy performed three years ago, with improvement in the faecal incontinence and better psychological outcome. The last caecostomy patient was an 8-year-old boy, with a similar clinical history and good progress in last three years after placing a Chait's button using an endoscopic procedure. Stubborn constipation continuing into adult life has a negative impact on the social and emotional adaptation of the paediatric patient, affecting family interactions. Antegrade colonic lavage allows independence and improves the quality of life in patients affected by recurrent faecal impactions. This technique needs to be performed on more patients to find out its true effectiveness.

UI MeSH Term Description Entries
D002431 Cecostomy Surgical construction of an opening into the CECUM with a tube through the ABDOMINAL WALL (tube cecostomy) or by skin level approach, in which the cecum is sewn to the surrounding PERITONEUM. Its primary purpose is decompression of colonic obstruction. Tube Cecostomy,Cecostomies,Cecostomies, Tube,Cecostomy, Tube,Tube Cecostomies
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D003248 Constipation Infrequent or difficult evacuation of FECES. These symptoms are associated with a variety of causes, including low DIETARY FIBER intake, emotional or nervous disturbances, systemic and structural disorders, drug-induced aggravation, and infections. Colonic Inertia,Dyschezia
D004733 Enema Insertion of a solution or compound through the RECTUM with the purpose of cleansing the COLON or for diagnostic procedures. Enemata,Enemas,Enematas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D001065 Appendix A worm-like blind tube extension from the CECUM. Vermiform Appendix,Appendix, Vermiform
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective

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