Analysis of adolescent morbidity based on inter-district center coloproctology
Science Articles / / May 02, 2016
Turutin AD, Christmas AI Igumenov AV, reindeer moss VA Vyskubov VN Slobodkin AY
In terms of reforming the health of one of the most pressing problems is the development of organizational and tactical aspects of the provision of specialized types of care for children's population.A promising area of such assistance is proctology.
Pathology rectum and colon, perineum, tailbone in children and adolescents has steadily increased.For constipation, requiring medical intervention and a detailed survey, there are already 10% of the child population, while 9.6% of all children with chronic abdominal pain is the cause of the disease of the colon.(Commissioners IA et al. 2001).Rectal prolapse is up to 4% of all childhood surgical diseases (Mirgorodtseva KS, Amin A. M. 1981).There is a growing urgency anorectal anomalies neyrointestinalnyh dysplasia, Hirschsprung's disease.These types of pathology began to meet more often in the last 15 years - from 1: 5000 to 1: 1500 (Krasouskaya T. et al 1987; Lenyushkin
special group of nonspecific inflammatory disease of the colon in children - ulcerative colitis and Crohn's disease.Over the last decade there has been significant increase in the incidence of severe disease in children and adolescents (Shcmerling, 1988).According to the experience of adult separation traced coloproctology clearly the effect of the concentration of these patients in a specialized regional center, against the background of the weekly endoscopic control.Number of surgical interventions for ulcerative colitis eventually reduced to sporadic cases.
very important for a large industrial center and treatment of children with "traditional" pathology of the colon - anal fissures, polyps, paraproctitis, rectal fistula, incontinence, injuries and their consequences, diseases of the coccyx, dermoid cyst, etc ..
Inthe above confirmation has been investigated the incidence of teenage coloproctological pathology at the example of the analysis of adolescents hospitalized and 18 in Coloproctology department of city clinical hospital №1 Togliatti.In just the past 4 years on hospitalization were 177 adolescents from 13 to 18 years inclusive.Young men were 89 (50.3%), 88 women (49.7%).Age groups are presented in Figure 1, it was dominated by a group of 18 year 54 (30.5%) and 17 - 46 year old patients (26.0%).This does not mean a sharp increase in the incidence of the achievement of puberty, the reason we believe that most of the teenage contingent hospitalized not coloproctological, and in children's surgical department, and was not included in our study.
Age distribution of adolescents hospitalized in Department of Coloproctology Fig.1
distribution nosology as follows
- epithelial coccygeal course of 85 patients (85.0%).including abscess formation 69 (81.2%), and for planned surgery 16 (18.8%), respectively;
- acute abscess - 37 patients (20.9%), including subcutaneous, submucosal - 13 patients (35.1%), ishiorektalny - 24 patients (64.9%), respectively;
- functional disorders of the colon - 13 (7.3%);
- nonspecific inflammatory diseases of the colon (ulcerative colitis and Crohn's disease) - 8 (4.5%);
- combined hemorrhoids - 7 (4.0%);
- a chronic anal fissure - 5 (2.8%);
- injury rectum and colon - 5 (2.8%);
- Hirschsprung's disease - 4 (2.3%);
- long-term effects after about malformations operations - 3 (1.7%);
- anokopchikovy pain, coccygodynia - 3 (1.7%);
- solitary ulcer of the rectum - 2 (1.1%);
- group colon polyps - 2 (1,1%);
- rhabdomyosarcoma anal sphincter - 1 (0.6%)
- postoperative fistula ileum - 1 (0.6%);
- prolapse of the rectum - 1 (0,6%)
received 104 patients (58.8%), in the scheduled 73 (41.2%) in a matter of urgency.In the structure of morbidity dominated pyo-inflammatory diseases adrectal fiber and complicated forms of epithelial coccygeal, very characteristic of puberty.Operational activity was quite high - 123 patients (69.5%) were operated, including emergency indications 90 patients, 73.2% of the operated patients.We observed no postoperative complications in the investigated age group.
Early diagnosis and optimal treatment of diseases of the colon in children and adolescents at a higher level as compared with the results of patients in specialized care institutions, creating the most favorable prospects for full recovery of the health of these patients, namely in specialized hospitals.