The loss of the rectum in children occurs significantly more often than in adults. This disease is observed mainly between the ages of 1 to 3.
The main reasons are congenital weakness of the perineum, insufficient fixation of the rectum due to the atrophy of the fatty fiber in weakened children. Conducting moments can be a variety of factors: colon diseases (dysentery, dyspepsia), hypotrophy, enhanced abdominal tension with constipation, long stay on the pot and DR. The frequency of loss of the rectum is associated with anatomy-physiological features of young children (small concaveness of the sacrum, the vertical position of the tailbone, the weakly pronounced lordosis and the low standing bottom of the bubble and bubble and bubble-recycling grooves). As a result, elevated intraperous pressure is directed directly to the pelvic bottom and the rectum. Boys fall into 2 - 3 times more often than girls.
Signs of loss of rectum
In the initial stages of the disease, only the mucous membrane falls and usually on the one hand; It is refilled independently. In the future, the loss becomes complete; At the same time, the gut has the form of a sausage cylindrical tumor of various sizes.
If the fallen intestine remains unlikely, it swells, bleeding is covered with fibrinous-purulent overlays, is ulced. With prolonged falling when the tone of the sphincter is still saved, the intestine is might. Describes the occasion of the intestine of the intestine and the development of peritonitis.
Loss usually occurs after defecation. Initially, when the tone of the pelvic bottom sink and the outer zoma is preserved, the right of the mucous membrane is accompanied by pain and difficult. In the future, with the hypotension of the muscles of the pelvic day, the intestine is easy to go on, but also easily falls out again. In severe cases, especially at weakened children, the intestine falls out with every fitting and scream, and the right of it is difficult to fall due to pronounced edema and thickening.
Diagnosis of rectal loss
Consultation of the Surgeon-Coloproktologist.
Diagnosis most often does not represent much difficulty. Errors are possible with an insufficient examination of the patient, when the supplied polyp is taken for the prolated intestine. Diagnostic error may occur when invagination if the integrated part of the intestine falls out of the rear pass. However, history, the overall condition of the child, inspection of the gut and the finger rectal research allows the surgeon to put the correct diagnosis.
Treatment of rectal falling
Treatment begins with conservative events. Often, for the occurrence of recovery, it is enough to normalize the intestinal function and facilitate defecation. It is important to prescribe a rational meal (calorie food with ballast restrictions). When the constipation inside is given sunflower or olive oil on 1 dessert spoon 3 - 4 times a day, clean the cleaning should be performed regularly. It is necessary to teach the patient not to sleep, for which it is for a month forbid a child to plant a pot. The child should be aimed lying on her side or on his back. This, combined with a lining treatment in most cases, is enough for recovery.
If the fallen intestine does not go on their own, the child is placed on the stomach and raise his legs up, ranking them at the same time on the parties. By smearing the grueling gut with vaseline oil, gradually and carefully send it. Start from the central part of the fallen intestine, where it is visible to the lumen, turning inside the dropped plot. As the central part of the intestine, its outdoor part goes inside the sam. After ordering the intestine of the child put on the stomach and reduce the buttocks. With regularly conducting the indicated activities and comply with the right regime, the rendering of the rectum in 90 - 95% of children up to 3-4 years old can be cured conservative.
If conservative treatment is unsuccessful, use alcohol injections to the paragrevy tissue on Mezennev (sclerosing therapy). This method leads to aseptic inflammation with the subsequent replacement of the loose fiber with a dense scar cloth holding the rectum in place.