HEMORRHOIDS IN THE PEDIATRIC POPULATION: CLINICAL MANIFESTATIONS, DIAGNOSTICS AND TREATMENT



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Introduction. Hemorrhoids in childhood is a rare disease. That is why one can find only few works on this problem. Material and methods. 56 children with diagnosed hemorrhoids aged 4-18 were taken into the study. They had various clinical manifestations of the disease: perianal protrusion (76.4%), bleeding (82.3%), pain syndrome (71.5%). 51 patient (91.1%) had external hemorrhoids; 3 children (5.3%) - internal; 2 children (3.6%) - combined. Patients, by their clinical course, were distributed as follows: acute hemorrhoids - 33 children (58.9%), chronic one - 23 (41.1%). Ultrasound examination and sigmoidoscopy were used for diagnostics. Different curative techniques followed the developed curative algorithm: conservative therapy and surgery (open surgery and with the LigaSure apparatus) as well as sclerotherapy. Results. The most effective technique, having better cosmetic and clinical outcomes, was hemorrhoidectomy. Conservative treatment (more than 80%) can be a method of choice at early stages of the disease and at younger age groups. Outcomes after sclerotherapy are comparable with outcomes of conservative and surgical treatment. Sclerotherapy is recommended at the internal stages of hemorrhoids and in case of any contraindications to surgical treatment.

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P. Aung

Pirogov Russian National Research Medical University (RNRMU)

编辑信件的主要联系方式.
Email: noemail@neicon.ru
ORCID iD: 0000-0002-2944-1366
俄罗斯联邦

V. Kholostova

Pirogov Russian National Research Medical University (RNRMU)

Email: vkholostova@yandex.ru
ORCID iD: 0000-0002-3463-9799
俄罗斯联邦

参考

  1. Azmy AA1.Bleeding rectal varices following injection sclerotherapy of oesophageal varices in a child. Z Kinderchir. 1987; 42(4):252.
  2. Bartosh AM, Siubryts’kyĭ MM. [Combined hemorrhoids in early childhood]. Klin Khir. 1998;(6):49-50.
  3. El-Mouzan MI1, Abdullah AM. Yield of colonoscopy in children with rectal bleeding. Saudi Med J. 2004 ;25(8):998-1001.
  4. Grossmann O1, Soccorso G1, Murthi G1. LigaSure Hemorrhoidectomy for Symptomatic Hemorrhoids: First Pediatric Experience. Eur J Pediatr Surg. 2015 ;25(4):377-80. doi: 10.1055/s-0034-1382258. Epub 2014 Jun 11.

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