ABSTRACT
Objective • To evaluate the clinical efficacy of laparoscopic-assisted Soave radical operation in the treatment of children with congenital megacolon. Methods • The clinical datum of 148 pediatric patients with congenital megacolon who had underwent laparoscopic-assisted Soave radical operation in Hainan General Hospital from Mar. 2012 to Sept. 2015 were collected. Operation time, blood volume lost during the operation, complication incidence during the hospitalization and follow-up period were analyzed, retrospectively. Results • All 148 patients were finished the surgery successfully. Operation time was (121.66±22.98) min, blood volume lost during the operation was (4.86±0.66) mL. During the hospitalization, the incidence of complications was 8.10%. There were no short-term complications observed on abdominal bleeding and anastomotic leakage. The patients were followed up for 24 months, there was one patient with anastomotic stoma stenosis at the 6 months after the operation, who recovered after the treatment of anal dilation. All the pediatric patients’ stool were mushy within 3 months after the operation, and they recovered to normal at the 6-12 months. The excellent rate of defecation function was 97.97%. There were no symptoms of bloated abdomen and astriction for all the patients during the follow-up period. Conclusion • Laparoscopic-assisted Soave radical operation is effective and safe for the treatment of children with congenital megacolon, with few complications, quick recovery, good short-term and long-term clinical effect.
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Objective:To evaluate the curative effect and safety of piperacillin/tazobactam in the treatment of children with con-genital gegacolon enteritis. Methods:122 cases of congenital intestinal enteritis were randomly divided into two groups. The 72 pa-tients in the treatment group were treated with piperacillin/tazobactam sodium, and the 50 patients in the control group were treated with cefoperazone/sulbactam. The course of treatment was 714 days. The differences in C-reactive proteins, bolld leukocytes count and neutrophilic granulocyte percentage before and after the treatment, and the average treatment time in both groups were compared, and the efficacy and bacterial clearance were evaluated. Results:Between the treatment group and the control group, the differences in C-reactive protein, blood leukocytes count and neutrophilic granulocyte precentage before and after the treatment had no statistical signifi-cance(P>0. 05). The effective rete of the treatment group was 86. 11%,and that of the control group was 88%(P>0. 05). The pos-itive detection rate of pathogenic bacteria was 75. 41%, in which Escherichia coli was the first pathogenic bacteria. The bacterial clear-ance in the treatment group was 85. 96%, which was higher than that (80%) in the control group(P>0. 05). Conclusion:The effi-cacy of piperacillin/tazobactam in the treatment of children with congenital megacolon enteritis is more obvious with promising safety.
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ABSTRACT: Hirschsprung's disease is a condition characterized by the absence of ganglion cells in a variable segment of the large intestine, mainly producing the symptom of constipation and being usually diagnosed in the first year of life. With diagnostic methods already established in the literature, the sole treatment is surgery. The objective of this study is to report a case of late diagnosis of the disease at age 13, with symptoms of fecal incontinence in its evolution. (AU)
RESUMO: A Doença de Hirschsprung é uma patologia caracterizada pela ausência de células ganglionares em um segmento variável do intestino grosso, produzindo principalmente o sintoma de constipação, sendo normalmente diagnosticada até o primeiro ano de vida. Com métodos diagnósticos já consagrados na literatura, o tratamento é exclusivamente cirúrgico. O objetivo deste trabalho é relatar um caso de diagnóstico tardio da doença, aos 13 anos, com sintomatologia de incontinência fecal na evolução do quadro. (AU)
Subject(s)
Humans , Female , Adolescent , Delayed Diagnosis , Hirschsprung Disease/diagnosis , Hirschsprung Disease/surgery , Hirschsprung Disease/pathologyABSTRACT
Antecedentes: la enfermedad de Hirschsprung es causa de obstrucción intestinal baja en neonatos. Se caracteriza por ausencia de inervación en un segmento intestinal. El tratamiento radica en la resección de ese segmento intestinal enfermo para permitir el funcionamiento correcto del intestino sano. Se analizó el manejo de esta patología en el Hospital Nacional de Niños Dr. Carlos Sáenz Herrera, durante el periodo 2000-2010 y su epidemiología. Métodos: se realizó un estudio observacional retrospectivo; se revisó 130 expedientes usando Microsoft Excel y el programa estadístico JMP. Resultados: se identificó una relación de hombre: mujer de 4:1, la mayoría de los casos se presentó en recién nacidos de término. Los síntomas iniciales más frecuentes fueron distensión abdominal y vómitos biliosos. La edad de presentación, en el 78 por ciento de los casos, fue de menos de 1 mes. Dentro de las cirugías realizadas se evidenció que en el 35 por ciento de los casos se utilizó la técnica del descenso endorrectaltransanal y en el 48 por ciento, la técnica de Duhamel. Entre las complicaciones postoperatorias en el grupo de descenso endorrectaltransanal, la más frecuente fue la enterocolitis, en 14 de 19 casos, mientras que la complicación más frecuente en el grupo de Duhamel, fue el tabique rectal, en 8 de 21 casos. Conclusión: las características clínicas y epiedemiológicas de los casos de enfermedad de Hirschsprung analizados, son similares a las descritas en la bibliografía. Las complicaciones postoperatorias y la morbilidad fue similar para ambas técnicas quirúrgicas...
Subject(s)
Humans , Male , Female , Infant, Newborn , Hirschsprung Disease , MethodsABSTRACT
Objective To explore the effect of two different enema methods in congenital megacolon children. Methods 70 cases of congenital megacolon children were randomly divided into the experimental group and the control group with 35 cases in each group respectively. The control group used traditional reflux-enema; The experimental group was implemented systemic and modified back reflux-enema (negative pressure drainage vessel to reflux-enema plus the padded-fixation of anal canals, cooperated with manual massage of lower abdomen along the direction of colon, if necessary, changed body position). The average enema time, the postoperative hospital stay and the effect of cleaning the intestine in the two groups were observed. Results Compared with the control group, the average preoperative enema time and hospitalization time was significantly shorter, and intestine cleaning effect was better in the experimental group. Conclusions Modified reflux-enema could increase preoperative enema time and postoperative hospitalization time, and had good effect on cleaning intestine.
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A special medical device for the treatment of congenital megacolon is designed.This device is made of avirulent and high-intensity plastics.The resultant which formed by up and down curve arm detained lateral anus can spur the up and down leaf of the ring clamp device.Under the continuous pressurized condition,it can clamp the rectum and the downward pull-through colon,then the colon becames necrosis,so that the aim of confluence is achieved.This device is disposable.
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Ileus caused by impaction of hardened residual barium stagnated in the colon, a rare complication of barium-enema examination, constitutes a particularly serious problem when it occurs in congenital megacolon patients. The administration of gastrografin in such case has proven efficacy in dissolution of impacted barium refratory to routine means of evacuation. We experienced a case of barium-impaction occurred in 6-months old male who had congenital megacolon. Gastrografin enema was a safe and simple method used in the management of this case.
Subject(s)
Humans , Infant , Male , Barium , Colon , Diatrizoate Meglumine , Enema , Hirschsprung Disease , IleusABSTRACT
Congenital atrichia is an anomaly characterized by congenital absence of hair in varying degrees as well as the ypopigmentation & poor development of the abnormal residual hair on the scalp, eyebrows, eyelashes & body. Two cases of congenital atrichia in siblings were reviewed. The first case was associated with congenital megacolon and skin biopsy of scalp (esp. parietal region) was non-specific. The second case was associated with bilateral inguinal hernia. Congenital atrichia is inherited by autosomal dominant or recessive. Acording to the limited pedigree data, our cases were X-linked recessive inheritance We report these cases with a review of related literatures.
Subject(s)
Humans , Biopsy , Eyebrows , Eyelashes , Hair , Hernia, Inguinal , Hirschsprung Disease , Pedigree , Rabeprazole , Scalp , Siblings , Skin , WillsABSTRACT
Congenital atrichia is an anomaly characterized by congenital absence of hair in varying degrees as well as the ypopigmentation & poor development of the abnormal residual hair on the scalp, eyebrows, eyelashes & body. Two cases of congenital atrichia in siblings were reviewed. The first case was associated with congenital megacolon and skin biopsy of scalp (esp. parietal region) was non-specific. The second case was associated with bilateral inguinal hernia. Congenital atrichia is inherited by autosomal dominant or recessive. Acording to the limited pedigree data, our cases were X-linked recessive inheritance We report these cases with a review of related literatures.
Subject(s)
Humans , Biopsy , Eyebrows , Eyelashes , Hair , Hernia, Inguinal , Hirschsprung Disease , Pedigree , Rabeprazole , Scalp , Siblings , Skin , WillsABSTRACT
A new radical operational procedure designed by ourselves has been used on 40 cases of congenital megacolon in our department during 1977-1991, The result of the follow-up sur- vey of 35 cases was gained. The operative curative rate was 97.1% and mortality was 2.9%. The characteristic is that the method of extraction by around-anastomosis stitches was used. Several important factors which affected operative effects were discussed. Four radical operational methods were compared. Our results demonstrate that the new method is effec- tive, safe, practical and feasible particularly in Yunnan. This study provides an ideal operational method in the clinical treatment of congenital megacolon.
ABSTRACT
Clinicostatistical datsa on 314 patients with congenital alimentary tract obstruction at the Department of Pediatrics and Pediatric Surgery of Seoul National University Hospital from January, 1974 to July, 1980 are presented and reviewed. The results are as follows; 1. Congenital megacolon(133 cases) is the most common congenital alimentary tract obstruction, and anorectal malformations(127 cases), congental duodenal obstruction(20 cass), esophageal atresia(12 cases), ileal atresia(9 cases), multiple intestinal atresia(2 cases), and colon atresia(2 cases), in given order of frequency. 2. The 20 cases of congenital duodenal obstruction included 15 male nad 5 female patients. The 10 cases were intrinsic obstruction(diaphragm of web; 4, atresia; 3, stenosis; 2, uncertain; 1) and the 10 cases were extrinsic obstruction(malrotation with or without Ladd's band, midgut volvulus: 9, preduodenal portal vein; 1). Associated anomalies were present in 3(1%) of the total. Operation was carried out in 19 patients and seven of them died. 3. The 22 cases of ileo-jejuno-colon atresia and stenosis included 14 male and 4 female patients. The majority of the patients involved ileum(9 cases), jejunum(9 cases), Jejunoileum(2 cases), and colon aresia was present in 2 cases. Associate anomalies were present in 7(32%) of the total. Operation was performed in 20 patients and seven of them died. 4. The 133 cases of congenital megacolon included 99 male and 34 female patients. The 121 case(91%) were short segment involvement and the remainders were long segment involovement. The 10 cases(8%) were associated with other malformations. In 118 patients operation was performed and the remainders were received conservative treatments, including enema. The 20 cases, 18% of the patients developed complications such as enterocolitis, incontinence, and so on. Three patients died during follow-up.
Subject(s)
Female , Humans , Male , Colon , Constriction, Pathologic , Duodenal Obstruction , Enema , Enterocolitis , Esophageal Atresia , Follow-Up Studies , Hirschsprung Disease , Intestinal Volvulus , NAD , Pediatrics , Portal Vein , SeoulABSTRACT
Clinicostatistical datsa on 314 patients with congenital alimentary tract obstruction at the Department of Pediatrics and Pediatric Surgery of Seoul National University Hospital from January, 1974 to July, 1980 are presented and reviewed. The results are as follows; 1. Congenital megacolon(133 cases) is the most common congenital alimentary tract obstruction, and anorectal malformations(127 cases), congental duodenal obstruction(20 cass), esophageal atresia(12 cases), ileal atresia(9 cases), multiple intestinal atresia(2 cases), and colon atresia(2 cases), in given order of frequency. 2. The 20 cases of congenital duodenal obstruction included 15 male nad 5 female patients. The 10 cases were intrinsic obstruction(diaphragm of web; 4, atresia; 3, stenosis; 2, uncertain; 1) and the 10 cases were extrinsic obstruction(malrotation with or without Ladd's band, midgut volvulus: 9, preduodenal portal vein; 1). Associated anomalies were present in 3(1%) of the total. Operation was carried out in 19 patients and seven of them died. 3. The 22 cases of ileo-jejuno-colon atresia and stenosis included 14 male and 4 female patients. The majority of the patients involved ileum(9 cases), jejunum(9 cases), Jejunoileum(2 cases), and colon aresia was present in 2 cases. Associate anomalies were present in 7(32%) of the total. Operation was performed in 20 patients and seven of them died. 4. The 133 cases of congenital megacolon included 99 male and 34 female patients. The 121 case(91%) were short segment involvement and the remainders were long segment involovement. The 10 cases(8%) were associated with other malformations. In 118 patients operation was performed and the remainders were received conservative treatments, including enema. The 20 cases, 18% of the patients developed complications such as enterocolitis, incontinence, and so on. Three patients died during follow-up.