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Anorectal Malformations (Part 3).

Bhatnagar S - J Neonatal Surg (2015)

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Surgery, B.J.Wadia Hospital for Children, Mumbai.

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(This section is meant for residents to check their understanding regarding a particular topic) What is long-term outcome for children with ARM? Fecal continence Constipation The terminologies used in the outcome analysis are constipation, urinary incontinence and fecal incontinence and must be clearly understood by the students and the researcher before categorizing the patients... Definition: The North American Society of Gastroenterology, Hepatology, and Nutrition (NASPGHAN) defines constipation as "a delay or difficulty in defecation, present for 2 weeks or more, and sufficient to cause significant distress to the patient." (8) The Paris Consensus on Childhood Constipation Terminology (PACCT) defines constipation as "a period of 8 weeks with at least 2 of the following symptoms: defecation frequency less than 3 times per week, fecal incontinence frequency greater than once per week, passage of large stools that clog the toilet, palpable abdominal or rectal fecal mass, stool withholding behavior, or painful defecation." (9) Definition: An inability to hold feces in the rectum due to failure of voluntary control over the anal sphincters permitting untimely passage of feces and gas is defined as fecal incontinence... A normal sensory innervation at all levels, i.e. spinal cord, brain stem, thalamus and cortex is mandatory for the normal defecation process to occur and hence those children with sacral spinal abnormalities could have a neurological cause of fecal incontinence wherein they are unable to appreciate the fecal consistency, differentiate the sense of feces from rectal gas, quantity of feces, and co-ordination with other actions of perineal and abdominal muscles... The clinical parameters of the child with anorectal malformations can predict and prognosticate the long-term outcome of these children which is tabulated in Table 2 and Table 3... Once a clinical evaluation is done and the severity of the fecal incontinence is assessed by utilizing the scoring system, further investigations are needed to ascertain the exact etiology of fecal incontinence... Table 5 provides the sequence of diagnostic tests and the management thereof... Nil The author is editor of the journal... The manuscript is independently handled by other editors and she is not involved in decision making about the manuscript.

No MeSH data available.


Table 2: Predictors of prognosis in patients with ARM
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Figure 2: Table 2: Predictors of prognosis in patients with ARM


Anorectal Malformations (Part 3).

Bhatnagar S - J Neonatal Surg (2015)

Table 2: Predictors of prognosis in patients with ARM
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4524202&req=5

Figure 2: Table 2: Predictors of prognosis in patients with ARM

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Surgery, B.J.Wadia Hospital for Children, Mumbai.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

(This section is meant for residents to check their understanding regarding a particular topic) What is long-term outcome for children with ARM? Fecal continence Constipation The terminologies used in the outcome analysis are constipation, urinary incontinence and fecal incontinence and must be clearly understood by the students and the researcher before categorizing the patients... Definition: The North American Society of Gastroenterology, Hepatology, and Nutrition (NASPGHAN) defines constipation as "a delay or difficulty in defecation, present for 2 weeks or more, and sufficient to cause significant distress to the patient." (8) The Paris Consensus on Childhood Constipation Terminology (PACCT) defines constipation as "a period of 8 weeks with at least 2 of the following symptoms: defecation frequency less than 3 times per week, fecal incontinence frequency greater than once per week, passage of large stools that clog the toilet, palpable abdominal or rectal fecal mass, stool withholding behavior, or painful defecation." (9) Definition: An inability to hold feces in the rectum due to failure of voluntary control over the anal sphincters permitting untimely passage of feces and gas is defined as fecal incontinence... A normal sensory innervation at all levels, i.e. spinal cord, brain stem, thalamus and cortex is mandatory for the normal defecation process to occur and hence those children with sacral spinal abnormalities could have a neurological cause of fecal incontinence wherein they are unable to appreciate the fecal consistency, differentiate the sense of feces from rectal gas, quantity of feces, and co-ordination with other actions of perineal and abdominal muscles... The clinical parameters of the child with anorectal malformations can predict and prognosticate the long-term outcome of these children which is tabulated in Table 2 and Table 3... Once a clinical evaluation is done and the severity of the fecal incontinence is assessed by utilizing the scoring system, further investigations are needed to ascertain the exact etiology of fecal incontinence... Table 5 provides the sequence of diagnostic tests and the management thereof... Nil The author is editor of the journal... The manuscript is independently handled by other editors and she is not involved in decision making about the manuscript.

No MeSH data available.