Abstract:
BACKGROUND:Faecal impaction is frequently observed in children with chronic constipation. The term megarectum is often used to describe this finding. AIM:To evaluate rectal functioning and rectal measures in constipated children with a filled rectum, in order to define the terms faecal impaction, enlarged rectum, and megarectum. METHODS:All children underwent radiological investigation, colonic transit time study, anorectal manometry, and rectal volume and rectal wall compliance measurements. Patients with faecal impaction were compared with controls, who had an empty rectum on digital rectal examination. RESULTS:A total of 31 patients and six controls were included in the study. The mean duration of complaints was 4.2 years and all had faecal incontinence. The colonic transit times in the patients showed a distinct delay in the rectosigmoid segment. Anorectal manometry was not significantly different between patients and controls. The rectal width in patients was 0.68 and in controls 0.52 with an upper limit of 0.61. The pressure-volume curve in patients showed significant less relaxation at a distension of 50 ml. The slope of the curve (corresponding with rectal wall compliance) was comparable for patients and controls. CONCLUSIONS:We suggest that faecal impaction is a filled rectum found on digital rectal examination; an enlarged rectum is defined by a rectopelvic ratio greater than 0.61; and megarectum is defined in those with significant abnormalities found with anorectal manometry, pressure-volume curves, or rectal compliance investigation. A diminished relaxation of the rectum on rectal distension could be the first sign of megarectum in children with chronic constipation.
journal_name
Arch Dis Childjournal_title
Archives of disease in childhoodauthors
van der Plas RN,Benninga MA,Staalman CR,Akkermans LM,Redekop WK,Taminiau JA,Buller HAdoi
10.1136/adc.83.1.52subject
Has Abstractpub_date
2000-07-01 00:00:00pages
52-8issue
1eissn
0003-9888issn
1468-2044journal_volume
83pub_type
杂志文章abstract::Congenital haemolytic anaemia in a 14 year old girl was caused by increased red cell membrane cation permeability. Potassium permeability was unusually sensitive to hydrostatic pressure and treatment with N-ethylmaleimide, factors which activate a specific chloride dependent potassium channel in cell membranes. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.58.7.547
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abstract:OBJECTIVE:There is a body of published research on the effectiveness of home visiting for the prevention of child maltreatment, but little in the peer reviewed literature on cost-effectiveness or value to society. The authors sought to determine the cost-effectiveness of alternative home visiting programmes to inform p...
journal_title:Archives of disease in childhood
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pub_type: 杂志文章,meta分析,评审
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journal_title:Archives of disease in childhood
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journal_title:Archives of disease in childhood
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journal_title:Archives of disease in childhood
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pub_type: 杂志文章
doi:10.1136/adc.57.11.867
更新日期:1982-11-01 00:00:00
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更新日期:2002-04-01 00:00:00
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doi:10.1136/adc.54.10.795
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pub_type: 杂志文章
doi:10.1136/adc.51.11.893
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更新日期:2002-01-01 00:00:00
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journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.66.4_spec_no.437
更新日期:1991-04-01 00:00:00
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journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
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