A child with chronic functional constipation – a challenge for a pediatrician alone or a surgeon as well? Case series and literature review

Abstract

Introduction:The role of surgical treatment for chronic functional constipation in children remains unclear. The objective of this study was to analyze clinical cases of patients qualified for surgical treatment. Material and methods: We analized data of 160 pediatric patients hospitalized in 2013-2021. Thirteen patients subjected to surgical treatment. Results:The study group consisted of 13 children. Organic causes of constipation were excluded. The duration of problems before qualification for surgical treatment averaged at 5.7 ±2.7 years. The most common symptoms were psychological disorders (13/13), abdominal pain (12/13) and fecal overflow incontinence (12/13). All patients were qualified for stepwise treatment: colostomy formation, segmental resection, and stoma closure. All children experienced subjective functional improvement. No severe surgical complications were observed. Conclusions: In cases of functional constipation refractory to conservative treatment,, surgical treatment facilitates immediate improvement in symptoms and social functioning. Any surgical treatment should be preceded by the exclusion of organic causes of constipation.

Desmosis coli as an extremely rare cause of constipation in children – case report and mini-review

“…The only treatment that might resolve the problem is surgical excision of the large intestine and performing an ileostomy. The extent of the surgery depends on the individual case [2][3][4][5][6]. Unfortunately, no information about the patients' follow-up can be found in the literature; hence, little is known about patients' outcomes after surgery.…”

“…Constipation is a relatively common condition affecting children. Functional constipation, which affects 0.5-32.2% of the paediatric population, is the most frequent type [1,2]. Rarely, its cause is organic, and amongst the organic causes, Hirschsprung disease (HD) remains the most common [3,4].…”