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[Fecal incontinence in Hirschsprung's disease in children]
Insights
Fecal incontinence after Hirschsprung
Area of Science:
- Pediatric Surgery
- Colorectal Surgery
- Pediatric Gastroenterology
Background:
- Hirschsprung's disease is a congenital disorder affecting the large intestine.
- Operative treatment aims to restore normal bowel function, including defecation control.
- Fecal incontinence is a potential complication following surgical correction.
Observation:
- The study evaluated 27 children experiencing fecal incontinence post-Duhamel operation for Hirschsprung's disease.
- Analysis focused on identifying the causes of persistent fecal incontinence.
- Investigated the role of anal sphincter, rectal adaptation, and levator ani muscle integrity.
Findings:
- Fecal incontinence can result from damage to the external anal sphincter, nerve plexuses, rectal adaptation issues, or levator ani muscle trauma.
- Severe damage to the levator ani muscles is a significant factor in post-operative fecal incontinence.
- The integrity of the levator ani muscle group is crucial for defecation control.
Implications:
- Identifying levator ani muscle damage is critical for managing fecal incontinence in pediatric Hirschsprung's disease patients.
- Surgical intervention to reconstruct the anorectal angle may be indicated in cases of severe levator ani muscle damage.
- This highlights the importance of preserving levator ani muscle function during Hirschsprung's disease surgery.
Abstract:
Among the criteria of evaluation of the results of operative treatment of Hirschsprung's disease in children, along with the absence of constipation is the function of defecation control. The authors examined 27 patients with fecal incontinence after Duhamel's operation. It was established that fecal incontinence in children after operative treatment of Hirschsprung's disease may be caused not only by affection of the external sphincter muscle of the anus, the nerve plexuses, and adaptation of the rectum to the new conditions after the pull-through operation, but also by trauma inflicted to the levator ani muscle. In children with severe damage to the levator group of muscles consequent upon operative treatment of Hirschsprung's disease, operative intervention for creating the anorectal angle is indicated.