NON-INVASIVE METHODS OF THE WORK-UP FOR ASSESSMENT OF MORPHOLOGIC AND FUNCTIONAL STATE OF THE SIGMOID WALL

Abstract

Background: Prolonged colonic congestion in children with chronic constipation and dolichosigma are characterized by a permanent imbalance of gut microflora, secondary inflammation and degeneration of the sigmoid wall. There is plenty of research papers on the optic non-invasive diagnostics in medicine, based on spectrophotometry and laser spectral analysis. Aim: To study morphologic and functional state of the sigmoid wall for detection of inflammation and degeneration in the sigmoid wall and optimization of treatment of children with dolichosigma and long-standing constipation. Materials and methods: From 2009 to 2014, 30 children with dolichosigma were seen in the Department of Pediatric surgery of MONIKI. All patients were hospitalized after unsuccessful conservative treatment in in-patient clinics of the Moscow Region. The children underwent a set of investigations for objective assessment of degree of the secondary inflammatory and degenerative abnormalities in the sigmoid wall, such as microbiological assessment, cytological assessment and fluorescent diagnostics. Results: There was no caused by dolichosigma. It maintains chronic inflammation and may play an indirect role in abnormalities of gut motor function. Inflammatory and degenerative abnormalities were confirmed by a cytological investigation of wall-adjacent biopsy of the sigma. The results of the complex assessment showed moderate inflammation and degeneration in the sigmoid wall in 20 children; subsequent conservative treatment of chronic colostasis was effective. Ten children had advanced secondary inflammatory and degenerative abnormalities of the sigmoid wall, with high levels of elastin and collagen in the colon wall. Surgery was performed in 6 children with the highest degree of fibrous transformation of the sigma. Conclusion: Complex assessment of the sigmoid wall, including fluorescent diagnostics and microbiological and cytological investigations, allows for detection and description of secondary inflammatory and degenerative abnormalities and subsequent choice of individualized treatment.