Related Experiment Videos
Malone appendicostomy: an unexpected complication
N Abbes Orabi1, H M Paterson, L Goncette
1Colorectal Surgery Unit, Department of Abdominal Surgery and Transplantation, St-Luc University Hospital, 10 Avenue Hippocrate, 1200 Brussels, Belgium.
Techniques in Coloproctology
|February 3, 2011
Summary
A rare complication of the Malone appendicostomy, a surgical procedure for fecal incontinence, is fecolith obstruction. This case report details successful surgical removal of a fecolith, restoring function.
Area of Science:
- Colorectal Surgery
- Surgical Complications
- Gastroenterology
Background:
- The Malone appendicostomy is a surgical option for managing fecal incontinence and chronic constipation.
- It facilitates antegrade colonic enemas for bowel evacuation.
- This technique is particularly relevant after abdominoperineal resection for rectal cancer.
Observation:
- A 54-year-old female with a history of rectal cancer surgery developed increasing difficulty with appendicostomy intubation and enema reflux.
- Radiology identified a 35 mm calcified fecolith obstructing the Malone appendicostomy.
- This obstruction significantly impaired the conduit's function.
Findings:
- Surgical exploration successfully removed the obstructing fecolith.
- The patient experienced a full recovery with restored appendicostomy function.
- This is the first reported case of a fecolith causing obstruction in a Malone appendicostomy.
Implications:
- Highlights a novel complication of the Malone appendicostomy procedure.
- Emphasizes the need for vigilance regarding potential obstructions in appendicostomy conduits.
- Surgical intervention can effectively resolve fecolith obstruction, restoring functional outcomes.
Related Concept Videos
01:19Appendicitis
Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...
01:22Appendicitis-I: Introduction
The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
01:21Inflammatory Bowel Disease V: Surgical Management
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:27Diverticular Disease of the Colon
Diverticular disease involves the formation of diverticula—small sac-like outpouchings of the colonic wall—and their complications. It most commonly affects the sigmoid colon due to higher intraluminal pressure and structural vulnerability. It results from structural weakness and increased pressure in the colon, producing pseudodiverticula that may remain silent or progress to inflammation and serious complications.Structure of DiverticulaIn diverticulosis, these outpouchings are...