Domina Conceptos Médicos

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Trastornos de Eliminación

Los LOS Neisseria trastornos de eliminación que se dan con más frecuencia en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la infancia son la enuresis Enuresis Involuntary discharge of urine after expected age of completed development of urinary control. This can happen during the daytime (diurnal enuresis) while one is awake or during sleep (nocturnal enuresis). Enuresis can be in children or in adults (as persistent primary enuresis and secondary adult-onset enuresis). Elimination Disorders (incontinencia urinaria) y la encopresis Encopresis Encopresis is the involuntary or unintentional passage of feces in inappropriate situations in children older than 4 years of age in the absence of neuromuscular disease. Elimination Disorders (incontinencia fecal en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum situaciones inadecuadas). La enuresis Enuresis Involuntary discharge of urine after expected age of completed development of urinary control. This can happen during the daytime (diurnal enuresis) while one is awake or during sleep (nocturnal enuresis). Enuresis can be in children or in adults (as persistent primary enuresis and secondary adult-onset enuresis). Elimination Disorders generalmente se diagnostica cuando los LOS Neisseria niños > 5 años de edad siguen mojando la cama. La enuresis Enuresis Involuntary discharge of urine after expected age of completed development of urinary control. This can happen during the daytime (diurnal enuresis) while one is awake or during sleep (nocturnal enuresis). Enuresis can be in children or in adults (as persistent primary enuresis and secondary adult-onset enuresis). Elimination Disorders puede producirse tanto de día (diurna) como de noche (nocturna). La incidencia de la enuresis Enuresis Involuntary discharge of urine after expected age of completed development of urinary control. This can happen during the daytime (diurnal enuresis) while one is awake or during sleep (nocturnal enuresis). Enuresis can be in children or in adults (as persistent primary enuresis and secondary adult-onset enuresis). Elimination Disorders nocturna se resuelve espontáneamente a un ritmo de aproximadamente 15% al AL Amyloidosis año. El tratamiento de la enuresis Enuresis Involuntary discharge of urine after expected age of completed development of urinary control. This can happen during the daytime (diurnal enuresis) while one is awake or during sleep (nocturnal enuresis). Enuresis can be in children or in adults (as persistent primary enuresis and secondary adult-onset enuresis). Elimination Disorders nocturna consiste principalmente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum modificaciones del comportamiento y del estilo de vida, pero puede incluir la desmopresina. La encopresis Encopresis Encopresis is the involuntary or unintentional passage of feces in inappropriate situations in children older than 4 years of age in the absence of neuromuscular disease. Elimination Disorders es, en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la mayoría de los LOS Neisseria casos, secundaria a estreñimiento subyacente, aunque también pueden intervenir factores de estrés emocional. El tratamiento se basa principalmente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el tratamiento del estreñimiento.

Last updated: Dec 15, 2025

Editorial responsibility: Stanley Oiseth, Lindsay Jones, Evelin Maza

Enuresis: Descripción General

Definición

  • Incontinencia urinaria involuntaria en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niños
  • Forma más común: enuresis Enuresis Involuntary discharge of urine after expected age of completed development of urinary control. This can happen during the daytime (diurnal enuresis) while one is awake or during sleep (nocturnal enuresis). Enuresis can be in children or in adults (as persistent primary enuresis and secondary adult-onset enuresis). Elimination Disorders nocturna monosintomática ( enuresis Enuresis Involuntary discharge of urine after expected age of completed development of urinary control. This can happen during the daytime (diurnal enuresis) while one is awake or during sleep (nocturnal enuresis). Enuresis can be in children or in adults (as persistent primary enuresis and secondary adult-onset enuresis). Elimination Disorders en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niños > 5 años sin signos de síntomas de tracto urinario)

Epidemiología

  • Enuresis Enuresis Involuntary discharge of urine after expected age of completed development of urinary control. This can happen during the daytime (diurnal enuresis) while one is awake or during sleep (nocturnal enuresis). Enuresis can be in children or in adults (as persistent primary enuresis and secondary adult-onset enuresis). Elimination Disorders nocturna monosintomática
    • Ocurre hasta en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el 15% de los LOS Neisseria niños de 5 años
    • Los LOS Neisseria varones tienen el doble de probabilidades de sufrir incontinencia urinaria nocturna.
    • La incidencia se resuelve espontáneamente, con una disminución aproximada de 15% al AL Amyloidosis año.
  • El 75% de los LOS Neisseria niños enuréticos tienen incontinencia nocturna.
  • El 25% de los LOS Neisseria niños enuréticos tienen incontinencia diurna.

Clasificación

  • Monosintomática versus no monosintomática
    • Monosintomática: se da en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niños sin antecedentes de problemas vesicales y sin signos de síntomas de tracto urinario
    • No monosintomática: se da en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niños con signos o síntomas de tracto urinario inferior
  • Primaria versus secundaria
    • Primaria: nunca se ha HA Hemolytic anemia (HA) is the term given to a large group of anemias that are caused by the premature destruction/hemolysis of circulating red blood cells (RBCs). Hemolysis can occur within (intravascular hemolysis) or outside the blood vessels (extravascular hemolysis). Hemolytic Anemia conseguido la continencia urinaria.
    • Secundaria:
      • Se consigue la continencia urinaria durante al AL Amyloidosis menos 6 meses y posteriormente se pierde el control.
      • A menudo asociada con cambios importantes en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la vida de un niño (nacimiento de un hermano, divorcio de los LOS Neisseria padres) o trauma emocional (abuso)
  • Momento de la enuresis Enuresis Involuntary discharge of urine after expected age of completed development of urinary control. This can happen during the daytime (diurnal enuresis) while one is awake or during sleep (nocturnal enuresis). Enuresis can be in children or in adults (as persistent primary enuresis and secondary adult-onset enuresis). Elimination Disorders
    • Diurna: incontinencia diurna
    • Nocturna: incontinencia nocturna
    • Mixta: incontinencia nocturna y diurna

Enuresis: Diagnóstico y Tratamiento

Evaluación clínica

El objetivo principal de la evaluación es determinar si existe una afección médica subyacente que pueda explicar la incontinencia (e.g., estreñimiento, diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus mellitus, diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus insípida).

  • Antecedentes:
    • Aumento de la frecuencia y/o urgencia urinaria
    • Frecuencia de la incontinencia
    • Ingesta de líquidos por la noche
    • Volumen de orina perdido durante los LOS Neisseria episodios
    • Duración de los “períodos secos” anteriores
    • Asociación con tenesmo o risa
    • Cambios estresantes recientes en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el hogar
    • Evaluaciones formales:
      • Sistema de puntuación del vaciado disfuncional
      • Vancouver Symptom Score para el síndrome de eliminación disfuncional
  • Examen físico:
    • Hipertensión (riesgo de nefropatía)
    • Abdomen doloroso a la palpación por heces retenidas (estreñimiento)
    • Anomalías en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la exploración neurológica del periné y/o de las extremidades inferiores (anomalías de la médula espinal)
    • Retraso en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria hitos del desarrollo (autismo)
    • Otros cambios de comportamiento (abuso)

Diagnóstico

El diagnóstico de la enuresis Enuresis Involuntary discharge of urine after expected age of completed development of urinary control. This can happen during the daytime (diurnal enuresis) while one is awake or during sleep (nocturnal enuresis). Enuresis can be in children or in adults (as persistent primary enuresis and secondary adult-onset enuresis). Elimination Disorders se realiza principalmente mediante los LOS Neisseria antecedentes, el examen físico y el análisis de orina.

  • Análisis de orina:
    • Generalmente de la primera orina del día
    • Herramienta de tamizaje para:
      • Estado de hidratación
      • Proteinuria Proteinuria The presence of proteins in the urine, an indicator of kidney diseases. Nephrotic Syndrome in Children
      • Hematuria Hematuria Presence of blood in the urine. Renal Cell Carcinoma
      • Cetoacidosis diabética
      • Diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus insípida
      • Intoxicación hídrica
      • Infección de las vías urinarias
  • Ultrasonido renal y cistouretrograma miccional:
    • Si el niño:
      • Es muy sintomático durante el día
      • Tiene antecedentes de infecciones del tracto urinario
      • Se sospecha que tiene anomalías estructurales renales
    • A menudo se utiliza junto con el ultrasonido para determinar el volumen residual postmiccional

Tratamiento

  • El tratamiento inicial incluye el tratamiento de cualquier afección médica subyacente.
  • Terapia conductual:
    • Tranquilizar a los LOS Neisseria padres y establecer objetivos razonables.
    • Educar a los LOS Neisseria padres para que no reprendan la enuresis Enuresis Involuntary discharge of urine after expected age of completed development of urinary control. This can happen during the daytime (diurnal enuresis) while one is awake or during sleep (nocturnal enuresis). Enuresis can be in children or in adults (as persistent primary enuresis and secondary adult-onset enuresis). Elimination Disorders.
    • Reducir el impacto de la enuresis Enuresis Involuntary discharge of urine after expected age of completed development of urinary control. This can happen during the daytime (diurnal enuresis) while one is awake or during sleep (nocturnal enuresis). Enuresis can be in children or in adults (as persistent primary enuresis and secondary adult-onset enuresis). Elimination Disorders.
    • Evitar despertar al AL Amyloidosis niño por la noche de forma rutinaria; utilice en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum su lugar una alarma de micción o de enuresis Enuresis Involuntary discharge of urine after expected age of completed development of urinary control. This can happen during the daytime (diurnal enuresis) while one is awake or during sleep (nocturnal enuresis). Enuresis can be in children or in adults (as persistent primary enuresis and secondary adult-onset enuresis). Elimination Disorders.
  • Modificación del estilo de vida:
    • Diario de vaciado
    • Limitar la ingesta de líquidos después de las 6 o 7 pm
    • Limitar el consumo de azúcar y cafeína después de las 5 pm
    • Fomentar la micción antes de acostarse
  • Terapia médica:
    • Primera línea: desmopresina
    • Segunda línea: antidepresivos tricíclicos

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Encopresis: Descripción General

Definición

La encopresis Encopresis Encopresis is the involuntary or unintentional passage of feces in inappropriate situations in children older than 4 years of age in the absence of neuromuscular disease. Elimination Disorders es la evacuación involuntaria o no intencionada de heces en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum situaciones inadecuadas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niños mayores de 4 años en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum ausencia de enfermedad neuromuscular.

Epidemiología

  • Ocurre en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum 1%–4% de los LOS Neisseria niños de 4 años
  • Más común en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niños que en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niñas (4–6:1)

Clasificación

Tipo Explicación
Retentiva Con estreñimiento y desbordamiento secundario y fugas alrededor de la obstrucción; más común
No retentiva Sin estreñimiento
Primaria Se observa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum varones desde la infancia; a menudo se asocia a un retraso global del desarrollo y a enuresis Enuresis Involuntary discharge of urine after expected age of completed development of urinary control. This can happen during the daytime (diurnal enuresis) while one is awake or during sleep (nocturnal enuresis). Enuresis can be in children or in adults (as persistent primary enuresis and secondary adult-onset enuresis). Elimination Disorders
Secundaria Se observa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niños después de un entrenamiento exitoso para ir al AL Amyloidosis baño; a menudo es de naturaleza funcional, marcado por un mayor nivel de estrés y trastornos psicológicos
Elimination disorders

En la encopresis retentiva, el estreñimiento subyacente puede provocar incontinencia por rebosamiento.

Imagen por Lecturio.

Etiología

  • Aproximadamente el 80% de los LOS Neisseria casos puede atribuirse al AL Amyloidosis estreñimiento (retentivo). Hay 3 momentos de la vida en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria que los LOS Neisseria niños son especialmente susceptibles:
    • Primera introducción de alimentos sólidos
    • Entrenamiento para ir al AL Amyloidosis baño
    • Inicio de la escuela
  • Tanto la encopresis Encopresis Encopresis is the involuntary or unintentional passage of feces in inappropriate situations in children older than 4 years of age in the absence of neuromuscular disease. Elimination Disorders retentiva como la no retentiva pueden estar asociadas a factores emocionales o ambientales, entre ellos:
    • Dificultades prematuras o imprevistas con el entrenamiento para ir al AL Amyloidosis baño
    • Alteraciones en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el horario del niño, incluyendo la dieta, el comienzo de la escuela y el entrenamiento para ir al AL Amyloidosis baño
    • Nacimiento de otro hijo o divorcio de los LOS Neisseria padres

Encopresis: Diagnóstico y Tratamiento

Evaluación clínica

Es importante realizar una toma cuidadosa de los LOS Neisseria antecedentes para determinar si existe una afección subyacente o si hay algún factor de estrés reciente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la vida del niño.

  • La encopresis Encopresis Encopresis is the involuntary or unintentional passage of feces in inappropriate situations in children older than 4 years of age in the absence of neuromuscular disease. Elimination Disorders o el estreñimiento funcional pueden diagnosticarse según los LOS Neisseria criterios de Roma IV. Un niño debe tener dos de los LOS Neisseria siguientes, al AL Amyloidosis menos una vez a la semana durante mínimo un mes:
    • Un episodio de incontinencia fecal
    • Postura retentiva o retención intencionada de las heces
    • Evidencia de un gran volumen de heces en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el recto
    • Episodios de heces de gran volumen que pueden obstruir el inodoro
    • Movimientos intestinales dolorosos
    • Dos o menos defecaciones a la semana
  • Retentiva:
    • Los LOS Neisseria padres pueden reportar un gran volumen de heces cuando se produce la defecación.
    • La defecación puede describirse como dolorosa.
    • El dolor Dolor Inflammation abdominal es una queja común asociada.
    • Una toma cuidadosa de los LOS Neisseria antecedentes dietéticos puede dar pistas sobre las causas del estreñimiento:
      • Consumo excesivo de lácteos
      • Ingesta insuficiente de fibra
  • No retentiva: a menudo asociada a incontinencia urinaria
  • Ambas:
    • Antecedentes de problemas de conducta concurrentes o un cambio reciente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el rendimiento escolar debido a acoso de los LOS Neisseria compañeros
    • Antecedente reciente de cambios potencialmente traumáticos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el hogar
    • Nacimiento reciente de un nuevo hermano, especialmente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum hijos únicos

Examen físico

  • Retentiva
    • General: manchas de heces en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la ropa interior
    • Examen rectal:
      • Revela grandes masas fecales en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes con estreñimiento funcional
      • Puede ayudar a evaluar el tono del esfínter para descartar patología neurológica
    • El examen abdominal puede indicar estreñimiento:
      • Puede estar distendido y ser ligeramente sensible a la palpación
      • Las heces pueden ser palpadas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la región suprapúbica
  • No retentiva: generalmente, el examen físico no es significativo
  • Ambas:
    • El examen físico es importante para descartar signos de otras causas patológicas de estreñimiento/incontinencia.
    • Inspección general:
      • Descartar desplazamiento anterior del ano.
      • Evaluar si hay signos de espina bífida oculta (hoyuelo sacro o mechones de pelo en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la parte baja de la espalda).
    • Examen neurológico: evaluar en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum busca de enfermedad neuromuscular subyacente, e.g.:
      • Tono muscular general
      • Reflejo del “guiño anal”
      • Reflejos de las extremidades inferiores

Imagenología

  • Retentiva:
    • La radiografía abdominal no se recomienda para la evaluación rutinaria
    • Si el examen no es concluyente debido al AL Amyloidosis hábito corporal/cooperatividad del paciente, puede ser útil documentar la carga fecal.
  • No retentiva: la radiografía de abdomen puede ser útil para comprobar que no hay carga fecal.
  • Ambas: la radiografía abdominal muestra el nivel de impactación fecal e identifica si hay megacolon Megacolon Megacolon is a severe, abnormal dilatation of the colon, and is classified as acute or chronic. There are many etiologies of megacolon, including neuropathic and dysmotility conditions, severe infections, ischemia, and inflammatory bowel disease. Megacolon o pseudoobstrucción intestinal.
Radiografía del trastorno de eliminación

Radiografías abdominales en bipedestación (A) y en posición supina (B), mostrando una gran cantidad de heces en el colon ascendente y descendente, sigmoide y recto. También puede observarse una dilatación en el segmento rectosigmoide, secundaria a la presencia de heces.

Imagen: “Radiografias de abdome em posição ortostática” por Traslaviña, G. A., Del Ciampo, L. A., & Ferraz, I. S. Licencia: CC BY 4.0

Tratamiento

  • Tratamiento médico de estreñimiento subyacente:
    • Polietilenglicol
    • Ablandadores de las heces
    • Laxantes orales (lactulosa, hidróxido de magnesio) o enemas (solución salina ± glicerina)
    • Terapia crónica con laxantes
  • Modificación del estilo de vida:
    • Normas para ir al AL Amyloidosis baño: haga que el niño se siente por 5 a 10 minutos después de las comidas para activar el reflejo gastrocólico.
    • Incluir una asociación positiva con la intervención (e.g., libros o una tableta).
    • Recompensar al AL Amyloidosis niño por haber defecado con éxito en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el inodoro.
    • No castigar al AL Amyloidosis niño por los LOS Neisseria intentos fallidos.
  • Modificaciones dietéticas:
    • Dieta rica en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum fibra (rica en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum verduras y frutas)
    • Aumento de la ingesta de líquidos
    • Eliminación de la leche de vaca
  • Asesoramiento psicológico si la causa es psicológica

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Diagnóstico Diferencial

Enuresis Enuresis Involuntary discharge of urine after expected age of completed development of urinary control. This can happen during the daytime (diurnal enuresis) while one is awake or during sleep (nocturnal enuresis). Enuresis can be in children or in adults (as persistent primary enuresis and secondary adult-onset enuresis). Elimination Disorders

Infección del tracto urinario (ITU): infección del tracto urinario por un patógeno, generalmente Escherichia coli fecal. En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria niños, las ITU pueden presentarse como cistitis, pielonefritis o bacteriuria Bacteriuria The presence of bacteria in the urine which is normally bacteria-free. These bacteria are from the urinary tract and are not contaminants of the surrounding tissues. Bacteriuria can be symptomatic or asymptomatic. Significant bacteriuria is an indicator of urinary tract infection. Urinary Tract Infections (UTIs) in Children asintomática. La disfunción de vaciado (vejiga neurógena) y la disfunción intestinal (estreñimiento pediátrico) se encuentran entre las causas más comunes.

Encopresis Encopresis Encopresis is the involuntary or unintentional passage of feces in inappropriate situations in children older than 4 years of age in the absence of neuromuscular disease. Elimination Disorders

  • Diarrea pediátrica: se define como la producción de heces > 10 ml/kg/día en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum lactantes y > 200 g/día en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niños mayores; puede ser aguda (< 2 semanas) o crónica (> 2 semanas) y se caracteriza por la pérdida excesiva de líquidos y electrolitos, e incluso por el retraso en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el crecimiento. Las manchas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la ropa interior que se observan en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria niños con encopresis Encopresis Encopresis is the involuntary or unintentional passage of feces in inappropriate situations in children older than 4 years of age in the absence of neuromuscular disease. Elimination Disorders pueden confundirse con heces diarreicas.
  • Disquecia del lactante: esfuerzo durante al AL Amyloidosis menos 10 minutos con signos de incomodidad asociados (llanto) en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum lactantes antes de defecar con éxito. Se cree que se debe a la contracción descoordinada de los LOS Neisseria músculos abdominales o a la falta de relajación de los LOS Neisseria músculos del suelo pélvico. La disquecia del lactante se resuelve espontáneamente con el tiempo.

Referencias

  1. Elder, J. S. (2020). Enuresis y disfunción miccional. In R. M. Kliegman MD et al. (Eds.), Nelson. tratado de pediatría (pp. 2816-2821). https://www.clinicalkey.es/#!/content/3-s2.0-B9788491136842005586
  2. Traslaviña, G. A. et al. (2015). Retenção urinária aguda em pré-escolar feminina com constipação intestinal [Acute urinary retention in a pre-school girl with constipation]. Revista paulista de pediatria: orgao oficial da Sociedade de Pediatria de Sao Paulo, 33(4), 488–492. https://doi.org/10.1016/j.rpped.2015.03.007
  3. Kliegman, R. M. et al. (2020). Trastornos de la motilidad y enfermedad de hirschsprung. In R. M. Kliegman MD et al. Nelson. tratado de pediatría (pp. 1955-1958). https://www.clinicalkey.es/#!/content/3-s2.0-B9788491136842003587
  4. Tu, N. D., Baskin, L. S., & Arnhym, A. M. (2024). Nocturnal enuresis in children: Etiology and evaluation. UpToDate. Retrieved August 5, 2025, from https://www.uptodate.com/contents/nocturnal-enuresis-in-children-etiology-and-evaluation

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