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Most children experience resolution of idiopathic pediatric rectal prolapse with bowel management alone.
- Source :
- Journal of Pediatric Surgery; Oct2022, Vol. 57 Issue 10, p354-358, 5p
- Publication Year :
- 2022
-
Abstract
- Recent studies in children with idiopathic rectal prolapse report up to 48% require surgical intervention to manage refractory disease. We sought to examine outcomes of our non-surgical approach to managing rectal prolapse using a bowel management program. A retrospective review was performed for all children with the diagnosis of rectal prolapse between 2011 and 2020. Children with a rectal polyp or hemorrhoid were excluded. 47 children with rectal prolapse were identified (median age at diagnosis of 4 years (IQR 3,7.75); age ≤ 4 years n = 30; age > 4 years n = 17). Associated diagnoses included constipation (n = 45, 96%) and psychiatric diagnoses (n = 7, 14%). Children underwent a bowel management program including stimulant laxatives in 44 (94%) and osmotic laxatives in 2 (4%). Median follow-up time was 181 days (IQR 77, 238). Median time to resolution of rectal prolapse was 9 months (IQR 4, 13) with a maximum time to resolution of 31 months. We compared children ≤ 4 years old (Group A) to those > 4 years old (Group B). Psychiatric diagnoses were less common in Group A (3.5 vs. 38.9%, p = 0.003). Median time to spontaneous resolution was 6.5 months (IQR 3.5, 9.5) in Group A versus 13.5 (IQR 4, 16) months in Group B, p = 0.13. No differences in surgical intervention were identified. Three (6.4%) patients required surgery for prolapse. A bowel management program is an effective treatment for most children with rectal prolapse. This data suggests that surgical intervention is unnecessary in most children. III. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00223468
- Volume :
- 57
- Issue :
- 10
- Database :
- Supplemental Index
- Journal :
- Journal of Pediatric Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 159027140
- Full Text :
- https://doi.org/10.1016/j.jpedsurg.2021.11.003