title: [Severe chronic constipation: limitations of medical therapy and indications for surgical intervention. II].
abstract: Severe chronic constipation is a common problem in children. Most patients have functional constipation, only few (approximately 5%) have an underlying organic disease who requires surgical treatment. Anatomic problems with a painful defecation (anal rhagades, fistulas, hemorrhoids) or with difficult defecation (anal stenosis, tumor) require only a careful physical examination. Other organic problems due to neurogenic and myogenic colonic abnormalities require extensive investigations, including histological and histochemical study, for diagnosis. Ultrashort Hirschprung's disease, neuronal intestinal dysplasia type B and hypoganglionosis represent different levels of a developmental problem of the enteric nervous system. Surgical treatment is recommended in these cases. After surgery is recommended a long period of medical treatment to avoid a functional constipation.
authors.affiliation: Divisione di Chirurgia Pediatrica, Ospedale Regionale di Vicenza, Italia.
authors.forename: P
authors.initials: P
authors.lastname: Campobasso
authors.forename: C
authors.initials: C
authors.lastname: Pesce
authors.forename: A
authors.initials: A
authors.lastname: Mercurella
authors.forename: M A
authors.initials: MA
authors.lastname: Fabbro
mesh_terms: D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003248:Constipation / Q000209:etiology*; D006627:Hirschsprung Disease / Q000150:complications; D006801:Humans; D007422:Intestines / Q000294:innervation
vernacular_title: Stipsi cronica severa: limiti della terapia medica e indicazioni all'intervento chirurgico. Parte seconda.