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Intestinal button implantation for obstipation and fecal impaction in children
Insights
A new technique uses a button gastrostomy device to treat chronic constipation and fecal impaction in children. This novel approach offers a long-term solution for pediatric patients with severe gastrointestinal motility issues.
Area of Science:
- Pediatric Gastroenterology
- Surgical Innovation
Background:
- Chronic obstipation and fecal impaction pose significant management challenges in pediatric care.
- Existing treatments may be insufficient for severe or recurrent cases.
Observation:
- A novel approach involved implanting a button gastrostomy device into the appendiceal stump or terminal ileum.
- This method was applied to two pediatric patients: one with pseudoobstruction syndrome and another with cystic fibrosis and meconium ileus equivalent.
Findings:
- Patients received a polyethylene glycol/electrolyte solution, with or without pancreatic enzymes, via the button device.
- Both children remained asymptomatic for at least 10 months post-procedure, indicating successful management.
Implications:
- This represents the first reported use of a button gastrostomy for managing chronic pediatric constipation and fecal impaction.
- The technique offers a promising, minimally invasive option for refractory cases, improving quality of life.
Abstract:
Chronic obstipation and fecal impaction in children can be difficult management problems for pediatricians. We describe a novel approach to the management of obstipation and fecal impaction: the implantation of the button gastrostomy device in the appendiceal stump or the terminal ileum. We report the procedure in two children. One child had pseudoobstruction syndrome complicated by recurrent obstipation; the other had cystic fibrosis complicated by recurrent obstruction from meconium ileus equivalent. Both children received a polyethylene glycol/electrolyte solution, with or without pancreatic enzymes, which was administered through the button. The children have remained essentially asymptomatic for at least 10 months. We believe that this is the first report of the use of a button gastrostomy device to successfully manage chronic obstipation and recurrent fecal impaction in children.