Related Experiment Videos
[Proctologic examination in pediatrics]
Insights
Pediatric rectal examinations revealed colitis in most cases, with amebic colitis identified in some. Sphincter hypotonicity was linked to diarrhea and malnutrition in children.
Area of Science:
- Pediatric Gastroenterology
- Proctology
Context:
- Rectal examinations are crucial for diagnosing pediatric gastrointestinal issues.
- Gastroenterocolitis is a common reason for these examinations in children.
Purpose:
- To analyze findings from rectal examinations, including inspection, digital rectal exam, and endoscopy, in a pediatric cohort.
- To identify the prevalence and types of rectal pathologies in children presenting with gastrointestinal symptoms.
Summary:
- 873 pediatric rectal examinations were conducted. Most children presented with gastroenterocolitis. External sphincter hypotonicity was observed in 146 cases, associated with prolonged diarrhea and malnutrition.
- Endoscopic findings included mucosal ulcerations, congestion, friability, edema, and bleeding. Colitis was diagnosed in 540 patients, with amebic colitis identified in 54 cases.
- Neoplastic lesions were rare, primarily leukemic infiltration or metastases. No procedure-related complications occurred.
Impact:
- Highlights the spectrum of rectal pathologies in children, emphasizing colitis and amebic colitis.
- Identifies prolonged diarrhea and malnutrition as risk factors for external sphincter hypotonicity in pediatric patients.
- Provides data on the diagnostic utility of combined endoscopic and fecal mucus examination for amebic colitis in children.
Abstract:
The study included 873 rectal examinations carried out in children where inspection, rectal examination and endoscopy were performed in each case. Most examinations were done in children complaining of gastroenterocolitis. Inspection of gluteal, perianal and sacrococcygeal areas was normal in most cases: however, ammoniacal erythema was frequently found (44.2%). Rectal examination showed hypotonicity of the external sphincter in 146 cases which was linked to prolonged diarrhea and malnutrition. At the endoscopy, the rectal mucosa showed ulcerations, congestion, friability, edema and bleeding; however, it was considered normal in 274 occasions. In 540 patients, the endoscopic diagnosis was colitis of different types. In 54 cases, the endoscopic examination, plus the examination of fecal mucus taken directly from the rectal mucosa led to the diagnosis of amebic colitis. In opposition with adults, neoplastic lesions were uncommon and usually corresponded to leukemic infiltration or tumoral metastases. There were no complications attributable to the process.