PURPOSE: Treatment of chronic constipation and fecal impaction is usually outpatient and requires high or frequent doses of laxatives. However, there are children who fail outpatient treatments, sometimes repeatedly, and are ultimately hospitalized. We sought to compare the characteristics of the children who failed outpatient treatment and needed inpatient treatment vs those who achieved success with outpatient treatment, in an effort to identify attributes that might be associated with a higher likelihood towards hospitalization. METHODS: In this retrospective cohort study, we reviewed the medical records of all patients aged 0 to 21 years, with chronic functional constipation and fecal impaction seen in the pediatric gastroenterology clinic over a period of 2 years. RESULTS: Total of 188 patients met inclusion criteria. While 69.2% were successfully treated outpatient (referred to as the outpatient group), 30.9% failed outpatient treatment and were hospitalized (referred to as the inpatient group). The characteristics of the inpatient group including age at onset of 3.6±3.6 years (p=0.02); black ethnicity (odds ratio [OR] 4.31, 95% confidence interval [95% CI] 2.04–9.09); p < 0.001); prematurity (OR 2.39, 95% CI 1.09–5.26; p=0.02]; developmental delay (OR 2.20, 95% CI 1.12–4.33; p=0.02); overflow incontinence (OR 2.26, 95% CI 1.12–4.53, p=0.02); picky eating habits (OR 2.02, 95% CI 1.00–4.08; p=0.04); number of ROME III criteria met: median 4, interquartile range 3–5 (p=0.04) and 13±13.7 constipation related prior encounters (p=0.001), were significantly different from the outpatient group. CONCLUSION: Identification of these characteristics may be helpful in anticipating challenges and potential barriers to effective outpatient treatment.
Age of Onset ; Child* ; Cohort Studies ; Constipation ; Eating ; Fecal Impaction* ; Gastroenterology ; Hospitalization ; Humans ; Inpatients* ; Laxatives ; Medical Records ; Outpatients* ; Pediatrics ; Retrospective Studies

Mass of the vulva include both benign and malignant lesions. Benign mass lesions of the vulva include tumors, hamartomas, cysts, infectious disorders, and non-neoplastic epithelial disorders. Some are rare mass lesions. Here, we presented three rare mass lesions of the vulva. The first case presented with the complaint of vulvar lesion since childhood, while the two cases presented in reproductive age and perimenopausal age. All three cases presented as mass lesions in the vulva with pain or uneasiness during work. In all these cases, excision was done. On histopathological examination, the lesions have different diagnoses which are common in other parts of the body, but rarely present at the vulva. A definitive diagnosis of a vulvar mass lesion is difficult to make, especially in the case of rare mass lesion. Histopathology is the principal tool of diagnosis.
Lymphangioma ; Fibroadenoma