POST-OPERATIVE ANORECTAL FUNCTIONAL DISTURBANCES IN CHILDREN IN CALABAR, NIGERIA

Between January 1993 and December 2001, 84 children aged between 0 and 15 years were treated with function problems of the anorectal region following surgical operations in the region. The age of maximum presentation was the 6 - 10 years age bracket. The main presenting complains were faecal soilage and poor bowel habit. The children notably presented late and they south medical attention as a result of societal embarrassment at school. Before this age the child was within the home environment hence partentd may not bother. Complications from anal agenesis operation accounted for the majority of patients 45 children (54%) while Hirschsprung's disease accounted for 39 patients (46%). Treatment in all cases started conservatively with diet manipulation. Cleansing enema and physiotherapeutic training. However, with non improvement in faecal soilage, a simple repair involving a narrowing at the anorectal function was carried out. In a follow-up period of between 6 - 12 months, 45 children had satisfactory clinical status while in 27 children their general condition had improved. The late presentation may have contributed to the overall improvement as the fibres of the external sphincter muscle perhaps have further develop.