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[Defecation disorders in children: treatment with colonic irrigation through an appendicostomy]

M M van den Berg1, B P Geerdes, H A Heij

  • 1Afd. Kindergastro-enterologie, Academisch Medisch Centrum/Universiteit van Amsterdam, locatie Emma Kinderziekenhuis, Meibergdreef 9, 1105 AZ Amsterdam.

Nederlands Tijdschrift Voor Geneeskunde
|March 9, 2005
PubMed

Insights

The Malone-stoma procedure, using the appendix for antegrade continence enemas, effectively treated severe constipation and fecal incontinence in three pediatric patients. This surgical option offers significant relief for children with complex bowel issues unresponsive to traditional therapies.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Colorectal Surgery

Background:

  • Severe constipation and fecal incontinence significantly impact children's psychosocial development.
  • Conventional therapies are often insufficient for complex pediatric bowel dysfunction.
  • The Malone-stoma procedure offers a surgical solution for refractory cases.

Observation:

  • Three pediatric patients with conditions including Hirschsprung's disease, chronic functional constipation, and meningomyelocele underwent the Malone-stoma procedure.
  • The appendix was utilized to create an open-ended stoma in the abdominal wall for antegrade bowel washouts.
  • Patients experienced complete resolution of bowel problems post-procedure.

Findings:

  • The Malone-stoma procedure demonstrated high efficacy, resolving bowel issues in all three treated patients.
  • Antegrade continence enemas facilitated by the stoma provided effective bowel management.
  • The treatment was effective in approximately 75% of similar pediatric cases.

Implications:

  • The Malone-stoma is a viable and effective treatment for severe pediatric constipation and fecal incontinence.
  • This surgical approach can significantly improve quality of life and psychosocial well-being in affected children.
  • While effective, potential complications such as stenosis require careful monitoring and management.

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