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Bowel imbrication in the management of anorectal anomalies

P A Dewan1, E Elsworthy, M Mathew

  • 1Department of Surgery, Sunshine Hospital, 3021 St. Albans, Victoria, Australia. paddy.dewan@wh.org.au

Pediatric Surgery International
|August 17, 2004
PubMed

Insights

Longitudinal imbrication successfully managed constipation in children with dilated rectosigmoid colon after anorectal anomaly surgery. This surgical technique improved bowel motions with minimal medication and short hospital stays.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Colorectal Surgery

Background:

  • Constipation is a common issue in patients with anorectal anomalies.
  • Significant rectosigmoid dilation can complicate management.
  • Previous surgical interventions may require revision.

Observation:

  • Four patients with anorectal anomalies and severe constipation underwent longitudinal imbrication of the rectosigmoid colon.
  • Three patients had primary anorectal anomalies with rectosigmoid dilation.
  • One patient with a cloacal anomaly and colonic atresia required small bowel reconstruction and subsequent imbrication for ectasia and diarrhea.

Findings:

  • Longitudinal imbrication of the dilated rectosigmoid segment effectively treated constipation in these patients.
  • One patient with small bowel ectasia also showed improvement after distal bowel imbrication.
  • All patients achieved near-normal bowel movements with minimal medication post-procedure.

Implications:

  • Longitudinal imbrication is a viable surgical option for selected patients with residual rectosigmoid dilation and constipation post-anorectal anomaly repair.
  • This technique offers a minimally invasive approach with favorable outcomes, including short hospital stays.
  • Careful patient selection is crucial for successful management of complex anorectal anomalies.

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