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Acta Médica Costarricense

versão On-line ISSN 0001-6002versão impressa ISSN 0001-6012

Resumo

MURILLO-ORTIZ, Juan Pablo; MONGE-NAVARRO, Silvia  e  HERRERA-QUESADA, Alonso. Chronical Constipation: identification of the causes at a Bowel Management Clinic. Acta méd. costarric [online]. 2016, vol.58, n.4, pp.166-170. ISSN 0001-6002.

Background:

Chronic constipation in the pediatric population is a common pathology that can affect the quality of life of the patient and the family. The initial experience at the Bowel Management Clinic is presented; patients with medical and surgical pathologies are included.

Methodology:

The clinical files from the Bowel Management Clinic at the Hospital “Dr. Maximiliano Peralta Jiménez” were reviewed, including all the patients evaluated between June 2012 to June 2015. The patients considered as active, are those who are presently in control at the clinic and patients considered as solved those patients who were evaluated initially and then referred to the pediatric outpatient clinic or surgery.

Results:

77 patients were included, 25 were active patients (35%) and 52 solved (65%), that were referred from the pediatric and pediatric surgery outpatients clinic for difficult management constipation. In the active patients the diagnoses are: 16 patients (64%) functional constipation, 6 patients (24%) Hirschsprung’s disease, 1 patient (4%) with Mowat Wilson’s Syndrome, 1 patient with spina bifida and 1 patient with ptosis of the transverse colon. The motive for consultation of the active patients was a chronic constipation in 20 patients (80%), Hirschsprung’s disease in 3 (12%) and encopresis in 2 patients (8%); the associated symptoms of this group of patients were: abdominal pain in 10 patients (40%), vomit in 3 patients (12%) and soiling in 19 patients (76%) From the 52 solved patients, 32 are men (61.5%) and 20 women. 44 patients (84.6%) have diagnosis of functional constipation, 6 (11.5%) Hirschsprung’s disease, 1 patient (1.9%) imperforated anus with perineal fistula and 1 patient with anal stenosis. The motive for consultation was chronic constipation in 47 patients (90%), anal stenosis in 1 (1.9%), anorectal malformation in 1 (1.9%) and inflammatory pelvic disease also in 1 patient (1.9%).

Conclusions:

The obtained results allow us to identify the most frequent causes of referral patients with chronic constipation to the Bowel Management Clinic at the Hospital “Dr. Maximiliano Peralta Jiménez”. From all the patients referred for constipation of difficult management 15 (19 %) were detected for surgical resolution.

Palavras-chave : constipation; Hirschsprung’s desease; encopresis; colostomy.

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