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Surgical Management of Idiopathic Constipation in Pediatric Patients

Lily S Cheng1, Allan M Goldstein2,3,4

  • 1Department of General Surgery, University of California San Francisco, San Francisco, California.

Clinics in Colon and Rectal Surgery
|March 1, 2018
PubMed

Insights

Idiopathic constipation in children is common, but rarely has an identifiable cause. This review details surgical options for children with severe constipation unresponsive to medical treatment.

Area of Science:

  • Pediatric Gastroenterology
  • Pediatric Surgery

Background:

  • Constipation affects many children, with identifiable causes in less than 5%.
  • Idiopathic constipation is a diagnosis of exclusion, requiring thorough clinical evaluation.
  • Medical management with laxatives is the primary treatment for most children.

Purpose of the Study:

  • To review surgical options for pediatric refractory constipation.
  • To guide the selection of appropriate surgical procedures for individual patients.

Main Methods:

  • Review of current literature on surgical management of pediatric constipation.
  • Analysis of various surgical techniques including anal procedures, antegrade colonic enemas, colorectal resection, and intestinal diversion.
  • Emphasis on preoperative testing and patient selection.

Main Results:

  • Surgical interventions can be effective for children with constipation unresponsive to medical therapy.
  • Careful patient selection and appropriate preoperative assessment are crucial for successful surgical outcomes.
  • A range of surgical options exists, tailored to specific patient needs.

Conclusions:

  • Surgical options are available for refractory pediatric constipation when medical management fails.
  • Judicious application of surgical procedures in well-selected patients can yield excellent results.
  • This review provides a framework for choosing the optimal surgical approach.

Keywords:
antegrade colonic enemascolorectal resectionconstipationfunctional constipationidiopathic constipation

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