Abstract
Aim: Constipation is a clinical entity; frequently seen in childhood and its medical treatment is unsuccessful in 40-50% of the cases. Children are isolated from their school and social life especially when encopresis develops together with constipation. In these kind of cases, if the rectum is extremely dilated due to constipation, the probability of get a response to medical treatment is very low. Material and
Method: The 5 megarectum cases occured due to functional chronic constipation treated surgically in our clinic between 2000 and 2008 were investigated in this study. Our cases were 4 males and 1 female with an age range of 9 to14 years (mean age: 11 years).
Results: Firstly, a procedure of protective right transverse loop colostomy and 6 months later, another procedure of low anterior resection were performed for all our cases with therapy resistant megarectum. After the colostomies were repaired, among all 5 cases; 3 regained their normal defecation habit by only using diet recommendations and did not need any medication; 1 needed oral laxative and enema’s; and 1 needed an additional operation for colostomy and a Swenson operation due to the recurrence of megarectum.
Conclusion: As a result, the gradual removal of the dilated rectum is thought to be an effective procedure that solves constipation and fecal incontinence in the postoperative period without needing any additional medical treatment in 60% of our cases with medical treatment resistant megarectum developed due to functional chronic constipation. However, the procedure of low anterior resection is not a suitable method for these kind of patients, because 40% of our cases still needed additional medical and surgical treatments
Keywords: Chronic, unremitting constipation, megarectum, child
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