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Incontinência fecal em crianças

  • 概述
  • 理论
  • 诊断
  • 治疗
  • 随访
  • 资源
最后审阅： 20 Aug 2025
最后更新： 09 Aug 2022

小结

定义

病史和体格检查

关键诊断因素

  • história de anormalidades anorretais, neurológicas ou espinhais ou cirurgia gastrointestinal
  • encoprese ou diarreia
  • constipação
  • irritação da pele perianal
  • exame retal anormal
  • deformidade espinhal
  • fraqueza e reflexos reduzidos ou ausentes
完整详情

其他诊断因素

  • problemas comportamentais
  • evacuações dolorosas
  • dor abdominal/cólica
  • postura descrita como contração das nádegas
  • enurese
  • malformação anorretal
  • exame abdominal anormal
  • história da afecção clínica subjacente
完整详情

危险因素

  • constipação crônica
  • sexo masculino
  • idade: 5 a 6 anos de idade
  • ausência de fibras alimentares
  • ingestão inadequada de líquidos
  • treinamento esfincteriano tardio ou inadequado
  • malformações anorretais
  • Doença de Hirschsprung
  • anormalidades espinhais
  • problemas psicológicos ou comportamentais devido a eventos familiares estressantes
  • transtornos psiquiátricos
  • uso excessivo de medicamentos
完整详情

诊断性检查

首要检查

  • radiografia abdominal
完整详情

需考虑的检查

  • enema de bário não preparado
  • radiografia da coluna total
  • RNM da coluna vertebral
  • radiografia de trânsito do marcador radiopaco
  • estudos de manometria anorretal e colônica
  • biópsia retal
  • hormônio estimulante da tireoide (TSH) sérico
  • nível de tiroxina livre sérica (T4)
  • teste de cloreto no suor
  • imunoglobulina A (IgA) transglutaminase tecidual
完整详情

治疗流程

急症处理

com constipação e impactação fecal

sem constipação

持续性治疗

impactação fecal remitida

撰稿人

作者

Brian D. Riedel, MD

Clinical Associate Professor of Pediatrics Emeritus

Pediatric Gastroenterology, Hepatology and Nutrition

West Virginia University School of Medicine

Morgantown

WV

利益声明

BDR declares that he has no competing interests.

鸣谢

Dr Brian D. Riedel would like to gratefully acknowledge Dr Linda S. Nield and Dr Uwe Blecker, previous contributors to this topic.

利益声明

UB declares that he has no competing interests. LSN is an author of a reference cited in this topic.

同行评议者

John C. Thomas, MD

Assistant Professor

Division of Pediatric Urology

Monroe Carell Jr. Children's Hospital at Vanderbilt

Nashville

TN

利益声明

JCT declares that he has no competing interests.

David C. A. Candy, MBBS, MSc, MD, FRCP, FRCPCH, FCU

Consultant Paediatrics Gastroenterologist

Western Sussex Hospitals NHS Trust

Chichester

Honorary Consultant Paediatric Gastroenterologist

Royal Alexandra Children's Hospital

Brighton and Sussex University Hospitals

Brighton

UK

利益声明

DCAC has received research grants, consultancy fees, and reimbursement of conference expenses from Norgine UK, the manufacturer of Movicol. He is the author of a systematic review of polyethylene glycol-based laxatives; convenor of the Paris Consensus on Constipation Terminology Group; and external advisor of the National Institute for Health and Care Excellence paediatric constipation guideline development group.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Hyams JS, Di Lorenzo C, Saps M, et al. Functional disorders: children and adolescents. Gastroenterology. 2016 May;150(6):1456-68. 摘要

Levitt MA, Pena A. Anorectal malformations. Orphanet J Rare Dis. 2007 Jul 26;2:33.全文  摘要

Bongers ME, Tabbers MM, Benninga MA. Functional nonretentive fecal incontinence in children. J Pediatr Gastroenterol Nutr. 2007 Jan;44(1):5-13.全文  摘要

Abrams P, Andersson KE, Apostolidis A, et al. 6th International Consultation on Incontinence. Recommendations of the International Scientific Committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse and faecal incontinence. Neurourol Urodyn. 2018 Sep;37(7):2271-2.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Incontinência fecal em crianças images

  • Diagnósticos diferenciais

    • Diarreia inespecífica infantil
    • Síndrome do intestino irritável com constipação e diarreia alternadas
    • Diarreia infecciosa
    Mais Diagnósticos diferenciais

  • Diretrizes

    • Constipation
    • Sixth International Consultation on Incontinence recommendations of the International Scientific Committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence
    Mais Diretrizes

  • Folhetos informativos para os pacientes

    Constipação em crianças

    Mais Folhetos informativos para os pacientes
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