= Abstract = 7 J- \l- Aj .£. 4:! .2l .>It, :f: 0 1-.2-j.>I1- Rectal Prolapse in Children Myung Duk Lee, M.D., Won Woo Kim, M.D. Department of Surgery, Pediatric Surgery, Kangnam St. Mary's Hospital, Catholic University Medical College Seoul, Korea Because rectal prolapse in pediatric age was known to have a self - limitting natural history in weeks to years, this disease is prone to be regarded as a minor codition to the most of surgeons. But to the children and the parents who have to be suffered each time could be a heavy distress. Even though operative or nonoperative methods can be applicable for treatment, the main problem is in surgeon's side, whose preference is based on the experiences of adult patients. The authors have experienced 16 cases of ano - rectal prolapse for 9 years since 1986. Eleven of them were true rectal prolapses. In 7 cases of true type, injec- tion therapy has been tried. One ml of five per cent phenol in glycerine was in- jected into the submucosal layer of the an o- rectal angle level at both lateral and posterior sides. After first trial of each cases, 5 of them were cured com- pletely so far. Recurrences were in two cases, but one of them was temporary to be subsided afterward. Complete bowel cleansing and adequate sedations were required as preoperative preparations. Two days' oral antibiotics and two weeks' laxatives for free of defecation straining were recommended after the procedure. The safety of sclerosis was supported by the experimental histology. In pediatric rectal prolapse, sclerosis seems to be a safe and effective treatement of choice without any significant morbidity. Index Words: Prolapse, Rectum, Sclerosis, Children .2. oJ oJ] rr}2.} 13 Ad -3{ %0 ] T rr}2.} o];<,Vd, rr} '* 1t31 -"d T S:J q'. oj 'B ojoJj - 133 -
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Rectal Prolapse in Children - KoreaMed...Rectal Prolapse in Children Myung Duk Lee, M.D., Won Woo Kim, M.D. Department of Surgery, Pediatric Surgery, Kangnam St. Mary's Hospital, Catholic
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= Abstract =
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Rectal Prolapse in Children
Myung Duk Lee, M.D., Won Woo Kim, M.D.
Department of Surgery, Pediatric Surgery, Kangnam St. Mary's Hospital, Catholic University Medical College
Seoul, Korea
Because rectal prolapse in pediatric age was known to have a self - limitting natural history in weeks to years, this disease is prone to be regarded as a minor codition to the most of surgeons. But to the children and the parents who have to be suffered each time could be a heavy distress. Even though operative or nonoperative methods can be applicable for treatment, the main problem is in surgeon's side, whose preference is based on the experiences of adult patients. The authors have experienced 16 cases of ano - rectal prolapse for 9 years since 1986. Eleven of them were true rectal prolapses. In 7 cases of true type, injection therapy has been tried. One ml of five per cent phenol in glycerine was injected into the submucosal layer of the ano- rectal angle level at both lateral and posterior sides. After first trial of each cases, 5 of them were cured completely so far. Recurrences were in two cases, but one of them was temporary to be subsided afterward. Complete bowel cleansing and adequate sedations were required as preoperative preparations. Two days' oral antibiotics and two weeks' laxatives for free of defecation straining were recommended after the procedure. The safety of sclerosis was supported by the experimental histology. In pediatric rectal prolapse, sclerosis seems to be a safe and effective treatement of choice without any significant morbidity.
Index Words: Prolapse, Rectum, Sclerosis, Children
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Fig. 2. Injection sclerosis procedure. Insert the index finger of operator's left hand into the anal cannal to guide the direction of needle into the submucosa of the rectum.
Fig. 4. Photomicrograph of rat intestine 2 weeks after sclerosis, showing marked submucosal fibro· sis with minimal inflammatory cells infilteration (HE staining, x 40). Increased wrinkling of mucosal folds looks more compacted in the lumen. There was no evidence of necrosis of mucosa, nor of muscularis.
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