| Seven years' experience with idiopathic unremitting chronic constipation. | |
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MedLine Citation:
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PMID: 2732875 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Two hundred sixty patients with severe chronic constipation were studied by rectal biopsy, barium enema, and anorectal manometry. None had any medical, neurologic, or anatomic cause for their complaint. All biopsies showed presence of ganglion cells and absence of hypertrophied nerves. Barium enemas showed a dilated anorectum (otherwise normal colon) in 183 (70%) and a normal anorectum and colon in 77 (30%). Manometry showed three patterns. One hundred seventy-eight patients (68%) had pressures between 0 and 20 mmHg with normal anorectal reflex, 69 (26%) had pressures between 0 and 20 mmHg with absence of anorectal reflex, and 13 (16%) had high pressures (20 to 60 mmHg) with normal anorectal reflex. One hundred seventy-eight patients (68%) were treated conservatively by diet and/or laxatives and did well. Eighty-two (32%) required a posterior internal sphincter myectomy after failure of prolonged conservative therapy. All patients were given senna postoperatively (one tablet or one teaspoon every night). Thirty-five patients (43%) did not require the senna after a few months and have daily bowel movements. Forty-two patients (51%) are still using senna. Ten (12%) experienced occasional impaction relieved by enemas. Two recurrences required reoperation. Five (6%) did not benefit from the operation. Sixteen had immunoperoxidase antineurofilament studies that showed no distinctive pattern as described by Kluck et al. |
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Authors:
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H Mishalany |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of pediatric surgery Volume: 24 ISSN: 0022-3468 ISO Abbreviation: J. Pediatr. Surg. Publication Date: 1989 Apr |
Date Detail:
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Created Date: 1989-07-27 Completed Date: 1989-07-27 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0052631 Medline TA: J Pediatr Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 360-2 Citation Subset: IM |
Affiliation:
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Division of Pediatric Surgery, Childrens Hospital of Los Angeles, University of Southern California School of Medicine 90027. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Barium Sulfate
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diagnostic use Biopsy Chronic Disease Constipation / pathology, physiopathology, radiography, surgery* Dilatation, Pathologic Humans Manometry Methods Pressure Rectum / pathology |
| Chemical | |
Reg. No./Substance:
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7727-43-7/Barium Sulfate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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