CLINIC, DIAGNOSIS AND EFFICIENCY OF NONINVASIVE METHOD OF TREATMENT YOUNG CHILDREN WITH HAEMORRHOIDS
Authors: Khamraev A. , Fayzullaev F. 
Published: December 2024

Hemorrhoids have been known since ancient times. They have always been considered the prerogative of adult patients. Methods of conservative and surgical treatment of hemorrhoids in adults are still used in children and often have negative results. Pediatric surgical practice has not optimized methods of diagnosis and treatment of hemorrhoids in infants and preschool children.
Materials and methods. The work was based on retrospective and prospective analysis of medical records and case histories of 112 children with hemorrhoids treated in the last 11 years. The number of patients under 1 year of age was 4 (0.4%); 1-3 years - 30 (26.4%); 3-6 years - 50 (44.6%); 7-12 years - 16 (14.2%); 13-18 years - 12 (10.7%). External hemorrhoids were found in 107 (95.5%), internal hemorrhoids in 4 (3.8%) and combined hemorrhoids in 1 (0.9%) patient. There were 70 (62.5%) boys and 42 (37.5%) girls.    All cases underwent general clinical and laboratory examination, orthostatic exercise (squatting), rectal palpation, anoscopy and rectoscopy. Statistical processing of the research materials was carried out using the method of variance statistics. All values in the work are presented in the form of arithmetic mean with calculation of standard deviation within the confidence interval. For all compared values the achieved level of significance (p) was considered statistically reliable - < 0.05. Student's t-distribution was used to compare data with normal distribution of means. When comparing 2 related groups, calculations were performed using Student's paired t-criterion. Microsoft Excel and Statistica computer programs were used for statistical data processing.
Results and discussion. This paper presents clinical material from the examination and treatment of 112 children with hemorrhoids over the past 11 years. The authors compare the characteristics of the etiopathogenesis of hemorrhoids in children from the literature and their own research data. The proposed non-invasive compression methods in the complex treatment of hemorrhoids in children are more effective in children of early and preschool age. A study of long-term results of complex conservative treatment of 84 patients of young age with hemorrhoids showed good results in 86,9%, satisfactory - in 9,5% and unsatisfactory (recurrence) - in 3,6% of patients. Surgical treatment of hemorrhoids in children was used only when conservative treatment was unsuccessful in 11 (12.6%) patients, with good long-term results in all cases. Indications for hemorrhoidectomy were: frequent prolapse of hemorrhoids (HU). After surgical treatment, good results were obtained in all cases; no recurrence was observed. The optimization of conservative and surgical treatment, respecting the age characteristics of children, led to good results.
Conclusions: 1. Examination of children with GU enlargement with the use of additional methods (ultrasound, RRS, FACS, PCI) of research allows to reveal and treat concomitant intestinal pathologies, which are the causes of secondary transient hemorrhoids development.  

For children of preschool age the most effective non-invasive method of treatment is rectal balonocompression. 3. After complex conservative treatment with rectal balonocompression of children with hemorrhoids good results were observed in 86,9% of children, satisfactory - in 9,5% and unsatisfactory - in 3,6%.