Abstract

RAMIREZ PEREZ, Carlos; ABREU SERA, Gladis; PEREZ MIR, Juan  and  MULET BATISTA, Dinorah. Treatment of the prolapse of the rectum in childhood with 16,5 % saline solution infiltration. Rev Cubana Pediatr [online]. 2011, vol.83, n.3, pp.327-334. ISSN 0034-7531.

Introduction: when the conservative medical treatment fails in children with prolapse of the rectum it is necessary the perirrectal infiltration with irritant substances. In 1990s these infiltrations in our center were carried out using glycerin, but due to be scarce in the market we must to find other alternative infiltrating agent. The objective of present paper is to describe the experience with the use of 16,5 % saline solution. Methods: an experimental, prospective, longitudinal and interventional study of non-controlled clinical trial was conducted. It consists of a second part in which we used the randomization with a control group for validation. Universe included 27 patients and sample included 16 patients with prolapse of the rectum over 2003-2007, seen in service of gastroenterology of the Provincial Children Hospital of Holguín province. The variables developed were: a concentration suitable for treatment, amount of substance to be infiltrated, complications, recurrence, number of infiltrations and the cure at a year. Results are showed in percentage tables. Results: the effectiveness of the 16,5 % saline solution was of 100 %, all patients cured and any had relapse, thus there were not necessary two or more treatment sessions. There was a comment on a child that, after failure of breast milk infiltration like a first option and also of the cerclage, finally, resolved with this method. Complications were relatively few (18,9 %): an abscess, a cellulitis and a urinary retention being necessary a catheterization for 2 weeks without subsequent sequelae. A randomization with the same number of patients was carried out using glycerin, where the use results of both substances were very similar and the number of complications was slightly greater in experimental group (6,2 %) one more case. Recurrence behaves in an inverse way with predominance in a 6,2 % in control group. To decrease the number of complications authors took into account the prophylactic use of antimicrobials, the day of procedure and over two days more. Conclusions: it was demonstrated that treatment of choice of the prolapse of the rectum in childhood is the infiltration and that only one session with 20 mL of saline solution (16,5 %) in each patient is a effective sclerosant agent.

Keywords : prolapse of the rectum; hypertonic saline solution; perirectal infiltration; perirectal sclerotherapy; sclerosant agents.

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