Abstract:
INTRODUCTION:Objectively evaluating the lack of bowel control (fecal incontinence) continues to be a challenge. Many have attempted to measure the severity of fecal incontinence and to evaluate its impact on the quality of life by developing standardized scoring systems. Some of these systems have been validated but none have achieved widespread use and all have limitations in evaluating pediatric patients. METHODS:A review of the literature was performed looking for validated scoring systems of fecal incontinence that are currently used for either adult or pediatric patients. The identified scoring systems were then critically analyzed and their applicability for managing fecally incontinent children considered. RESULTS:Thirteen of the most frequently used fecal incontinence scoring systems were selected (6 for adults and 7 for children). Quality of life questionnaires were excluded not only because of their length and complexity, but mostly because they do not accurately reflect a measurement of bowel control. Our analysis revealed that all pediatric scoring systems require some degree of interpretation as they included at least one subjective parameter. These unverifiable subjective parameters were: "sensation of rectal fullness", "sphincter squeeze", and "anal shape". Equally problematic, the pediatric systems frequently focused on factors unrelated to fecal continence such as "frequency of bowel movements", "rectal prolapse", "abdominal pain", "blood in the stool", "leakage of urine", "diarrhea", and "constipation". The most objective system found from our review is the Krickenbeck system, which focuses upon two objective factors. Those two factors are the absence of voluntary bowel movements and the presence of soiling in the underwear. The major weakness of the Krickenbeck system is that it does not allow for reassessment after medical or surgical interventions. In this paper, we propose a modification of the Krickenbeck system that allows for such an assessment to be applied to those patients who are able to achieve voluntary bowel movements with the aid of laxatives or constipating agents. CONCLUSIONS:Most scoring systems are flawed because they invite bias and interpretation due to their subjective nature, while systems focused on measuring quality of life do not address the fundamental issue of bowel control. The Krickenbeck score seems to be the most applicable and objective method of evaluating bowel control in pediatric patients that may be more useful when modified to assess patients after medical intervention.
journal_name
Pediatr Surg Intjournal_title
Pediatric surgery internationalauthors
Bischoff A,Bealer J,Peña Adoi
10.1007/s00383-016-3909-ysubject
Has Abstractpub_date
2016-08-01 00:00:00pages
737-41issue
8eissn
0179-0358issn
1437-9813pii
10.1007/s00383-016-3909-yjournal_volume
32pub_type
杂志文章,评审abstract::A previous study documented the effects of maternal corticosteroid treatment on structural growth and functional development in fetal lungs associated with pathogenic conditions such as oligohydramnios using immunohistochemical and morphometric analyses. The purpose of the present study was to examine the effect of ma...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-007-1979-6
更新日期:2007-10-01 00:00:00
abstract:PURPOSE:To compare the effect of home intravenous (IV) versus oral antibiotic therapy on complication rates and resource utilization following appendectomy for perforated appendicitis. METHODS:This was a randomized controlled trial of patients aged 4-17 with surgically treated perforated appendicitis from January 2011...
journal_title:Pediatric surgery international
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00383-018-4343-0
更新日期:2018-12-01 00:00:00
abstract:UNLABELLED:Anorectal malformation (ARM) is a group of significant birth defects with geographic variation in incidence, individual phenotypes and regional geographic subtypes occurring in approximately 1:5,000 live births. Anorectal atresia with gross terminal colonic distension in the presence of an absent anal canal ...
journal_title:Pediatric surgery international
pub_type: 杂志文章,多中心研究
doi:10.1007/s00383-013-3346-0
更新日期:2013-12-01 00:00:00
abstract::Non-accidental trauma (NAT) represents a significant cause of morbidity and mortality in the pediatric population. The management of these patients often involves many care providers including the surgeon. Victims of NAT often present with multiple injuries and as such should be treated as trauma patients with complet...
journal_title:Pediatric surgery international
pub_type: 杂志文章,评审
doi:10.1007/s00383-015-3688-x
更新日期:2015-07-01 00:00:00
abstract::In children with severe chronic constipation, abnormal distribution of substance P (SP) and vasoactive intestinal peptide (VIP), which represent excitatory and inhibitory nerves, respectively, has been reported. The normal distribution of these neuropeptides, however, is not well known. The aim of this study was to de...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s003830050438
更新日期:1998-11-01 00:00:00
abstract::The aim of this study was to determine whether barium enema reduction (BER) is safe and effective in patients with a long duration of intussusception. Over the last 17 years, 104 patients were admitted to our hospital with a diagnosis of intussusception. All except 1 with peritonitis underwent BER primarily. Of the 10...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s003830050526
更新日期:1999-01-01 00:00:00
abstract::We review a single surgeon and surgical centre's experience with congenital cystic adenomatoid malformation of the lung (CCAML) in relation to clinical spectrum, operative experience, and postoperative course. A retrospective hospital record review was done on surgically treated cases of CCAML over a 10-year period, f...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-004-1225-4
更新日期:2004-07-01 00:00:00
abstract::Premature male ischiopagus tetrapus twins weighing 2.2 kg were born unexpectedly. They required initial ventilation for respiratory distress syndrome and an emergency laparotomy for intestinal obstruction at 10 days of age. At 8 months of age, formal separation was carried out. Primary skin closure was possible withou...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/BF01372144
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND:There is a shortage of surgeons in Africa, and this shortage is particularly acute in paediatric surgery with most paediatric patients being cared for by general surgeons. The use of information technology to augment teaching in paediatric surgery in Africa is appealing but often unsuccessful due to the cost...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-010-2806-z
更新日期:2011-04-01 00:00:00
abstract::An isolated bowel segment (IBS) is a viable loop of bowel that is completely free of its mesenteric attachments. In this study, omentoenteropexy (OEP) was performed in 5-cm-long IBS of rats in order to provide neovascularization. Thirty-two rats were divided into four groups. After OEP, mesenteric division of the IBSs...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/BF01076940
更新日期:1997-07-01 00:00:00
abstract::Manual reduction with the index finger (modified Hutchinson's maneuver) enabling simple and safe manual reduction of infantile intussusception is described. The procedure was used in four patients, two boys and two girls, ranging in age from 2 to 15 months, as greater than normal compression was necessary and/or seros...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s003830050301
更新日期:1998-03-01 00:00:00
abstract::Rhabdomyosarcoma (RMS) is the most common soft tissue tumour in children. This is the first time a facial RMS metastatic to the pancreas is reported. The patient was a 3-year-old boy with a symptomatic solitary pancreatic metastasis of a primary facial RMS, with already one relapse in a submental lymph node. Since thi...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-009-2539-z
更新日期:2010-03-01 00:00:00
abstract::It is widely accepted that there are degenerative changes and decreased spermatogenesis in the contralateral descended testis (CDT) in unilateral undescended testis (UUDT). While some investigators have postulated that the mechanism may be related to primary (congenital) or secondary (autoimmune, vascular, and neural)...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s003830000532
更新日期:2001-07-01 00:00:00
abstract::At bilateral orchiopexy bilateral biopsies may be indicated to determine fertility potential. It is currently unknown if the serum inhibin B levels at time of orchiopexy reflect the testicular status of the bilaterally cryptorchid child. The aim of this study was to relate the results of inhibin B and FSH measurements...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-006-1839-9
更新日期:2007-02-01 00:00:00
abstract::Liver transplantation (LT) for malignancy has had disappointing long-term results due to tumour recurrence. Ex-vivo dissection and auto-transplantation have had poor results when the tumor was obstructing bile ducts. Advances in liver surgery have made extensive liver resection safer, but cases of "unresectable" tumou...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s003830000531
更新日期:2001-07-01 00:00:00
abstract::Congenital arteriovenous fistulas are a rare cause of neck mass in children, but should be considered in the differential diagnosis of paediatric patients presenting with pulsatile neck masses even when there is no history of trauma. Balloon embolisation is the treatment of choice because of the high risk of surgical ...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-011-2918-0
更新日期:2011-12-01 00:00:00
abstract::Gastroschisis closure is performed either primarily or after staged reduction of the prolapsed bowel. A technique for surgical closure of the abdominal wall defect is described which allows for an almost scarless appearance of the abdominal surface with preservation of a midline umbilicus. ...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-008-2215-8
更新日期:2008-09-01 00:00:00
abstract:PURPOSE:Although the precise pathogenesis of ventral body wall (VBW) defects is not clearly understood, it has recently postulated that disruption of somite development during early embryogenesis may cause failure of proper VBW formation. The administration of cadmium (Cd) after 60 h of incubation induces omphalocele s...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-011-2994-1
更新日期:2012-02-01 00:00:00
abstract::Accessory hepatic tissue, unlike accessory splenic and pancreatic tissue, is rare and has a limited and almost exclusively sub diaphragmatic distribution. Fewer than ten cases of intrathoracic ectopic liver have been reported so far in the literature. This paper reports a case that caused a diagnostic dilemma. ...
journal_title:Pediatric surgery international
pub_type: 杂志文章,评审
doi:10.1007/s003830000520
更新日期:2001-07-01 00:00:00
abstract::In many very-low-birth-weight (VLBW) infants the ductus arteriosus fails to close spontaneously, and they subsequently develop signs and symptoms of poor tissue perfusion and heart failure. This study evalutes the results of early surgical closure of patent ductus arteriosus (PDA). We retrospectively reviewed the reco...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s003830000515
更新日期:2001-07-01 00:00:00
abstract::Endoscopic management is the accepted form of treatment for posterior urethral valves (PUV). The Nd:YAG laser has been in clinical use for many decades, but has been used only sporadically for ablating PUV. In this study, PUV were diagnosed by micturating cystourethrogram (MCU). In the 9-month period beginning March 1...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s003830050018
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:The natural history of patients with antenatally diagnosed congenital cystic adenomatoid malformation of the lung (CCAM) is still fully unknown. In symptomatic patients with respiratory distress, an operation is performed during the neonatal period. However, in asymptomatic patients, the optimal timing of th...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-009-2431-x
更新日期:2009-09-01 00:00:00
abstract::A case of bilateral urinary tract tuberculosis presenting with acute renal failure is reported. It is believed to be the first reported instance of the disease presenting in this form. The patient was managed with preliminary high diversion followed by bilateral replacement of the ureters with ileal loops that were an...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s003830050291
更新日期:1998-03-01 00:00:00
abstract:INTRODUCTION:Hepatoportoenterostomy (HPE) with the Kasai procedure is the treatment of choice for biliary atresia (BA) as the initial surgery. However, the appropriate level of dissection level of the fibrous cone (FC) of the porta hepatis (PH) is frequently unclear, and the procedure sometimes results in unsuccessful ...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-015-3799-4
更新日期:2015-12-01 00:00:00
abstract::Mucosa-associated lymphoid tissue (MALT) lymphomas comprise a group of indolent B-cell non-Hodgkin lymphomas (NHL), which are rare in pediatric age. The clinical presentation of MALT lymphomas varies according to the location of the lymphoma. We report on a case of MALT lymphoma involving the appendix in a 6-year-old ...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-007-1957-z
更新日期:2008-04-01 00:00:00
abstract:PURPOSE:Controversy exists as regards the best non-invasive diagnostic tool for pediatric cervical lymphadenopathy. The current work aimed to evaluate the reliability, sensitivity, specificity, and accuracy of sonoelastography in diagnosing benign and/or malignant pediatric cervical lymphadenopathy. METHODS:Prospectiv...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-018-4301-x
更新日期:2018-08-01 00:00:00
abstract::Anorectal malformations (ARM) remain a significant birth defect with geographic variation in incidence, individual phenotypes and regional geographic subtypes. Although early studies indicated a low incidence in Black patients, there is a great paucity of knowledge as to the types, frequency and incidence of ARMs enco...
journal_title:Pediatric surgery international
pub_type: 杂志文章,多中心研究
doi:10.1007/s00383-008-2131-y
更新日期:2008-06-01 00:00:00
abstract:AIM OF THE STUDY:Liver retraction during laparoscopic fundoplication is important for obtaining an optimal space. Several methods have been developed, but the risks and benefits are unclear. We compared three different approaches and evaluated their safety and utility. METHODS:Forty-three neurologically impaired patie...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-020-04646-8
更新日期:2020-05-01 00:00:00
abstract::Inflammatory pseudotumors (IPT) are uncommon mass lesions arising most typically in the lungs of young adults. These tumors are so named because of the difficulty in distinguishing them preoperatively from malignant lesions. IPT are characterized histologically by localized fibrous proliferations with infiltration by ...
journal_title:Pediatric surgery international
pub_type: 杂志文章,评审
doi:10.1007/s003830000518
更新日期:2001-09-01 00:00:00
abstract:PURPOSE:To date, no detailed study of the changes in the image-defined risk factors (IDRFs) after neoadjuvant chemotherapy has been performed. The aim of this study was to investigate the effect of chemotherapy on IDRFs for stage L2 neuroblastomas. METHODS:Fifteen stage L2 patients treated by neoadjuvant chemotherapy ...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-016-3858-5
更新日期:2016-03-01 00:00:00