encoparesis

Question 1

task

Answer 1

pg 471

Question 2

d/d

Question 3

hx

Answer 3

HOPC
-for how long
-Was he toilet-trained before
-any h/o constipation : 3 months back hard stools, with blood>resolved with laxatives
-abdominal pain, vomiting
-diet : fruits and veggies
-low
-how is urine noamr, day time incontinence
-how is school? friends?progress?
-home situation : siblings, stable parents

Question 4

exam

Answer 4

shy boy
-growth chart
-abdomen : soft, fecal mass
-anus : fissures
-rectal exam : hard stool

Question 5

explanation

Answer 5

-most likely diagnosis chronic constipation due to anal fissure 3months back.
-chronic constipation>dilatation rectum and lower colon
-liquefaction of faeces>over flow>but hard mass still remains
-start as anal fissure>fear >chronic constipation
-explore other etiologies

Question 6

mx

Answer 6

1.empty large bowel : high dose laxatives, enema, suppository
2.not success>oral GI Lavage golytely
3.Maintain regular bowel habit
-with laxatives stool softeners
-ct therapy for many months>megacolon resolves and ensure passage of motion not painful
4.R/V - make sure no constipation