Andreas Martin Fette
University of Pecs, Germany
Scientific Tracks Abstracts: Clin Pediatr
Approximately 12% of patients with bowel emptying disorders under 16 years of age shows signs of mega bowel development. In addition, 25% adolescents and young adults with chronic constipation have already developed a megacolon. Thus, any bowel emptying disorder with signs of mega bowel will constitute a key indication for early and complete diagnostics to give these patients the opportunity to have a healthy large bowel in adulthood. However, among others, the development of a mega bowel is always an alarming sign in front of the immanent (irreversible) bowel wall injury. We would like to report on two Arab children, who have been presented with the main complaints overflow-incontinence and megasigma/rectum. In front of the language barrier, cultural issues and limited technical equipment taking history, clinical examination and compliance have been difficult. After exclusion of the key differential diagnosis elongated sigma and Hirschsprung‚??s disease, medical textbooks have been revisited for the exact definition of terms in regard to our potential final diagnoses ‚??dolichosigma‚?Ě, ‚??megarectum‚?Ě, ‚??rectal inertia syndrome‚?Ě and ‚??(overflow-) incontinence‚?Ě, respectively to create an individual treatment plan tailored for each of our patients. Both kids underwent elective surgery. Intraoperative, a massively enlarged bowel segment has been found, resected and sent for histopathology. The children‚??s postsurgical course have been uneventful, both kids have been reporting continence afterwards. In conclusion, the psychological strain of all children and families involved seems to be the same among all cultures. Pathophysiology is known to be manifold, too. All diagnostic steps and the treatment algorithm are standardized, however, at least for us, some questions remain unanswered.
Andreas Martin Fette has earned his Doctoral degree from the Johannes Gutenberg University, Medical School in Mainz Germany in 1992. He has also completed his Clinical Training in all subspecialities in several accredited European Pediatric Surgery training centers before he passed successfully National and European Board certification in Surgery and Pediatric Surgery. In all day clinical practice he headed several WHO accredited projects and developed the specialty of pediatric surgery in many developing or Third World countries. In 2010, he has completed his PhD studies at the University of Pecs Medical School, Hungary. Since then, he received Professorship and acted as a Senior Lecturer at international universities. He has authored more than 20 book chapters, published nearly 100 peer reviewed journal articles and presented more than 200 lectures at international congresses.
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