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A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
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Ten-year experience using antegrade enemas in children.

Suzanne M Mugie1, Rodrigo S Machado, Hayat M Mousa

  • 1Division of Gastroenterology, Nationwide Children's Hospital, Columbus, OH, USA. s.m.mugie@amc.nl

The Journal of Pediatrics
|June 12, 2012
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Summary

Antegrade enemas are a safe and effective treatment for severe pediatric defecatory disorders, with 71% of patients becoming symptom-free. Success is linked to stimulant laxative use and factors like percutaneous placement.

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Area of Science:

  • Pediatric Gastroenterology
  • Colorectal Surgery
  • Functional Bowel Disorders

Background:

  • Severe defecatory disorders in children pose significant management challenges.
  • Traditional treatments may be insufficient for complex cases.
  • Antegrade enemas offer an alternative route for bowel management.

Purpose of the Study:

  • To evaluate the 10-year experience with antegrade enemas in pediatric patients.
  • To identify factors associated with successful outcomes.
  • To assess the safety and efficacy of this therapeutic option.

Main Methods:

  • Retrospective analysis of 99 pediatric patients undergoing cecostomy for antegrade enema delivery.
  • Data collected on patient demographics, underlying conditions, placement method, and outcomes.
  • Statistical analysis to identify predictors of poor outcomes.

Main Results:

  • 71% of patients achieved symptom resolution with antegrade enemas.
  • Poor outcomes were associated with surgical cecostomy placement, younger age, and specific comorbidities (Hirschsprung's disease, cerebral palsy).
  • Use of stimulant laxatives in irrigation solutions significantly improved outcomes (P < .001).

Conclusions:

  • Antegrade enemas are a successful and relatively safe therapeutic option for children with severe defecatory disorders.
  • Identifying prognostic factors aids in patient selection and management.
  • This approach can lead to long-term symptom control and cecostomy removal in select cases.