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Pediatric Surgery International
ISSN: 0179-0358 (printed version) ISSN: pending (electronic version)
Table of Contents Abstract Volume 13 Issue 5/6 (1998) pp 437-439
case report: Currarino's triad: an unusual cause of constipation in children
M. Zia-ul-Miraj, R. J. Brereton Department of Paediatric Surgery, Chelsea and Westminster Hospital, 369-Fulham Road, London SW10 9NH, UK
Accepted: 21 March 1997 Abstract A 6-year-old girl presented with intractable constipation. On investigation, she was found to have an association of anorectal stenosis, anterior sacral defect, and anterior meningocoele (Currarino's triad). The meningocoele was excised and a Duhamel pull-through procedure performed after resection of a massively distended rectosigmoid. Post-operatively, she started having spontaneous bowel action. Early diagnosis and management is recommended to avoid the high mortality and morbidity associated with this condition.
Publisher: BMJ Publishing Group
Sigmoidoscopy in minor lower gastrointestinal bleeding
ARCHIVES OF DISEASE IN CHILDHOOD
March 1998, vol. 78, no. 3, pp. 267-268(2)
Balkan E.[1]; Krtolu I.[1]; Gürpnar A.[1]; Özel I.[1]; Snmaz K.[1]; oruyol H.[1]
[1] Uluda University Medical Faculty, Department of Paediatric Surgery, Bursa, Turkey
[*]Dr Emin Balkan, Uluda niversitesi Tp Fakültesi Çocuk Cerrahisi ABD Görükle, Bursa, Türkiye, TR-16059.
Abstract:
The role of sigmoidoscopic examination in the diagnosis, evaluation, and treatment of minor lower gastrointestinal bleeding was investigated. A hundred patients with minor rectal bleeding were examined by rigid sigmoidoscopy under general anaesthesia between January 1989 and July 1996. Patients who had bleeding secondary to infections, anal fissure, or haemorrhoids were excluded from study. Patients were reviewed retrospectively according to their diagnosis and endoscopic and histopathological findings. Twenty nine of these patients were girls and 71 boys; their ages ranged between 8 month and 14 years (mean 7.2 years). Endoscopic pathological findings were established in 60 patients; 32 had rectal polyps, 16 non-specific proctitis, four solitary rectal ulcers, three internal haemorrhoids, two ulcerative colitis, two Hirschsprung's enterocolitis, and one haemangioma. It is concluded that sigmoidoscopic examination should be performed for the diagnosis, prognosis, and choice of treatment in patients with minor rectal bleeding and the diagnosis should be confirmed histopathologically.
English Document Type: Original article ISSN: 0003-9888
Publisher: BMJ Publishing Group
Comparison of a low dose polyethylene glycol electrolyte solution with lactulose for treatment of chronic constipation
GUT, February 1999, vol. 44, no. 2, pp. 226-230(5)
Ménard A-M.[1]; Attar A.[2]; Moreau J.[3]; Boutron M-C.[2]; Naudin G.[4]; Flourié B.[2]; Barthet M.[5]; Lémann M.[6]; Ferguson A.[7]; Halphen M.[8]; Alix E.[9]; Salmeron M.[10]; Guillemot F.[11]; Chaussade S.[12]
[1] Service de Gériatrie, Hôpital de Villiers-Le-Bel, France
[10] Service de Gastroentérologie, Hôpital de La Croix-Saint-Simon, Paris, France [11] Service de Gastroentérologie, Hôpital Claude Huriez, Lille, France
[12] Service de Gastroentérologie, Hôpital Cochin, Paris, France
[2] Service de Gastroentérologie, Hôpital Saint-Lazare, Paris, France
[3] Service de Gastroentérologie, Hôpital Rangueil, Toulouse, France
[4] Service de Gastroentérologie, Hôpital des Diaconnesses, Paris, France
[5] Service de Gastroentérologie, Hôpital Sainte-Marguerite, Marseille, France
[6] Service de Gastroentérologie, Hôpital Saint-Louis, Paris, France
[7] Gastrointestinal Unit, Western General Hospital, Edinburgh, UK
[8] Norgine Pharma, Paris, France
[9] Service de Gériatrie, Hôpital du Mans, France
[*]Dr M Lémann, Service de Gastroentérologie, Hôpital Saint-Louis, 1 avenue Claude Vellefaux, 75010, Paris, France.
Abstract:
Background Polyethylene glycol (PEG) 3350 is a non-absorbable, non-metabolised osmotic agent used in lavage solutions for gut cleansing. Aims To compare the efficacy of PEG and lactulose in chronic constipation. Methods A total of 115 patients with chronic constipation entered a multicentre, randomised, comparative trial. They initially received two sachets containing either PEG (13 g/sachet) or lactulose (10 g/sachet) and were given an option to change the dose to one or three sachets/day, depending on response. Results Ninety nine patients completed the trial. After four weeks, patients in the PEG group (n=50) had a higher number of stools and a lower median daily score for straining at stool than patients in the lactulose group (n=49). Overall improvement was greater in the PEG group. Clinical tolerance was similar in the two groups, but flatus was less frequently reported in the PEG group. The mean number of liquid stools was higher in the PEG group but the difference was significant only for the first two weeks. There were no serious adverse events and no significant change in laboratory tests in either group. At the end of the study, the number of sachets used by the patients was 1.6 (0.7)/day in the PEG group and 2.1 (0.7)/day in the lactulose group. Sixty one patients completed a further two months open study of one to three sachets PEG daily; there was no loss of efficacy and no serious toxicity. Conclusion Low dose PEG 3350 was more effective than lactulose and better tolerated.
Keywords: constipation; polyethylene glycol; lactulose; cathartics; randomised trial
Language: English Document Type:
Original article ISSN: 0017-5749 Publisher:
BMJ Publishing Group