Clinical Outcome and Long Term Follow-up of Chronic Functional Constipation in Children / 대한소아소화기영양학회지

PURPOSE: The purpose of this study was to evaluate the long term outcome and the factors contributing to treatment outcome for chronic functional constipation in children. METHODS: Sixty three children were enrolled who had chronic functional constipation and could be followed by telephone contact. They were treated at the Bucheon Soonchunhyang Hospital for more than 1 month and observed from March 2001 to June 2005. We analyzed the clinical features, symptoms and signs, as well as the course and results of treatment. RESULTS: The male to female ratio was 35 (55.6%) : 28 (44.4%). The mean age at the onset of symptoms and diagnosis was 21.1+/-23.5 (1.9~84.0) months and 47.1+/-34.2 (6.9~138.0) months, respectively. The mean defecation frequency before treatment was 3.2+/-2.3 (0.5~10.0) times per week. The symptoms associated with constipation were as follows: soiling 34 (54.0%) which was more common in males than females, large stools in 30 (47.6%), decreased bowel movements less than three times a week in 20 (31.7%), straining during defecation in 19 (30.2%) and retentive posturing 19 (30.2%). The mean duration of follow-up was 34.2+/-14.6 (3.6~60.0) months and 44 (69.8%) patients had their symptoms resolve ("success") and 19 (30.2%) were not resloved ("fail") from the constipation. The time for recovery from soiling, straining during defecation and retentive posturing after treatment was 4.3+/-2.4 (1.0~36.0), 5.0+/-1.4 (0.8~36.0) and 5.0+/-3.1 (1.0~36.0) months, respectively. A relapse of the constipation occurred in 15 (23.8%) patients, 9 (60%) boys and 6 (40%) girls. The time to relapse after cessation of treatment was 2.9+/-1.9 (1.0~6.0) months and the only risk factor associated with relapse was the initial duration of treatment. CONCLUSION: Most of the patients had resolution of symptoms within five months after treatment; relapse occurred within three months after the interruption of treatment. The duration of treatment was important for recovery and for the prevention of relapse in the constipated children. Thus a long term maintenance of therapy and follow-up is necessary for chronic functional constipation in children.

Treatment of Congenital Chylothorax in a Premature Infant using Octreotide

Chylothorax, defined as escape of chyle from the thoracic duct into the thoracic cavity, is the most common cause of pleural effusion during the neonatal period. The use of octreotide, a synthetic analogue of the somatostatin, for the treatment of congenital idiopathic chylothorax, has not been previously reported in Korea. We report here a case of idiopathic congenital chylothrax successfully treated with octreotide in a premature infant who showed no response to conservative therapies.