[Diagnosis and treatment of pediatric anismus].
OBJECTIVE
To explore the diagnosis and treatment methods of pediatric anismus.


METHODS
Twenty-nine patients with idiopathic chronic constipation, diagnosed with anismus by colon barium contrast and anorectal manometry from Nov. 2001 to Nov. 2004 in our hospital, were investigated retrospectively.


RESULTS
This group consisted of 13 men and 16 women whose mean age was (6.7+/-4.0) years. Hirschsprung diseases were excluded from the patients by colon barium contrast and rectoanal inhibitory reflex (RAIR) examination. Normal RAIR (5-10 ml elicited) was showed on 21 cases while weakened RAIR (15-30 ml elicited) was showed on 8 cases. After the diagnosis, the patients were treated by toilet training, diet regulation and laxative for 1-2 months. 4 cases were recovered, 5 cases were improved and 20 cases were relied on glycerin suppository. Four cases, relied on glycerin suppository, underwent Lynn procedure and had good results after 5-24 months follow-up. Two cases were re-examined by anorectal manometry 3 and 6 months after surgery, the resting pressure and the high pressure zone (HPZ) decreased, but the simulation defecation reflex was still abnormal.


CONCLUSIONS
The diagnosis of pediatric anismus relies on history of constipation, combined with anorectal manometry and colon barium contrast. Lynn procedure could be chosen for the patients unsatisfied in toilet training and other non-operative treatment.
Ding
Shu-qing
SQ
The Third Affiliated Hospital, Nanjing University of Traditional Chinese Medicine, National Central of Colorectal Surgery, Nanjing 210001, China. njgczx@public1.ptt.js.cn
Ding
Yi-jiang
YJ
Chen
Yong-tian
YT
Ye
Hui
H
D000293:Adolescent; D001004:Anus Diseases / Q000175:diagnosis / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009123:Muscle Hypotonia / Q000175:diagnosis* / Q000601:surgery*; D017773:Pelvic Floor / Q000503:physiopathology*; D012002:Rectal Diseases / Q000175:diagnosis / Q000601:surgery