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Arch Hellen Med, 28(5), September-October 2011, 692-697


The surgical management of organic constipation in children aged over one year

S. Roupakias, E. Smaropoulos
Department of Pediatric Surgery, "Hippokration" General Hospital of Thessaloniki, Thessaloniki, Greece

Constipation with an organic cause mainly arises in the neonatal period and during infancy, with the transition from breast feeding to formula milk. In children older than one year, functional constipation is diagnosed in more than 95% of cases of difficulty in passing stools. This is a report of experience in the evaluation and management of children older than one year of age suffering from constipation with an organic cause. In the period 2006−2009, three children with a history of chronic constipation, one with cystic fibrosis and two with Hirschsprung's disease, were successfully investigated and treated surgically. Constipation in childhood is usually functional and only rarely is there a serious organic cause. Pediatricians and family physicians must be on the alert for "red flags" that may indicate the presence of an uncommon but serious reason for constipation, such as Hirschsprung's disease, hypothyroidism, diabetes insipidus, cystic fibrosis, gluten enteropathy or congenital anorectal malformation, especially when the traditional conservative methods of treatment fail. The findings from the careful history and physical examination are instrumental in differentiating between functional and organic constipation in children.

Key words: Children, Constipation, Surgical approach.

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