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imperforate anus constipation

David J Hiller, Jaime L Bohl, Kristen A Zeller
Rectal prolapse is the protrusion of the rectum out of the anus. Surgical correction can be accomplished via open and minimally invasive abdominal approaches, as well as from the perineum. Robotic rectopexy is an option for minimally invasive treatment of rectal prolapse. There are no studies that have established the efficacy of robotic rectopexy for rectal prolapse in the pediatric population. The aim of this study was to review the experience of robotic rectopexy at a single institution. This is a retrospective review of our pediatric robotic rectopexy experience from 2012 to 2015...
December 1, 2017: American Surgeon
Cengiz Tavusbay, Hüdai Genç, İrfan Karaca, Kemal Atahan, Mehmet Hacıyanlı, Erdal Türk
Anorectal malformations are rare occurrences characterized by the absence or abnormal localization of the anus. Clinical manifestations can vary from mild forms that require only minor surgery to more complicated cases that must be managed with multi-staged surgery. In this report, our aim is to present the clinical characteristics, management, and treatment outcome of an adult patient with an anorectal malformation with a vestibular fistula that was successfully repaired by posterior sagittal anorectoplasty (PSARP) and to discuss the case in the light of the relevant literature...
2017: Turkish Journal of Surgery
Josef Finsterer, Marlies Frank
Mitochondrial disorders (MIDs) due to respiratory-chain defects or nonrespiratory chain defects are usually multisystem conditions [mitochondrial multiorgan disorder syndrome (MIMODS)] affecting the central nervous system (CNS), peripheral nervous system, eyes, ears, endocrine organs, heart, kidneys, bone marrow, lungs, arteries, and also the intestinal tract. Frequent gastrointestinal (GI) manifestations of MIDs include poor appetite, gastroesophageal sphincter dysfunction, constipation, dysphagia, vomiting, gastroparesis, GI pseudo-obstruction, diarrhea, or pancreatitis and hepatopathy...
January 2017: Therapeutic Advances in Gastroenterology
Pablo Caro-Domínguez, Juan Bass, Julie Hurteau-Miller
In 1981, Currarino et al described a triad of findings that consist of partial sacral dysgenesis, presacral mass (anterior meningocele, enteric cyst, or presacral teratoma) and anorectal malformation. Currarino syndrome exhibits variable expressivity and the clinical presentation tends to vary with the age of the subject such as spinal anomaly detected in the fetus, imperforate anus in the newborn, and intractable constipation or neurologic symptoms in the infant and older child. At any age, meningitis can be the presenting symptom and imaging is required for proper investigation...
February 2017: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
Saleh M Eftaiha, George Melich, Ajit Pai, Slawomir J Marecik, Leela M Prasad, John J Park
INTRODUCTION: Bowel dysfunction (fecal incontinence and constipation) presents in over 50% of patients after treatment of congenital anal malformations. Sacral nerve stimulation (SNS) for the treatment of fecal incontinence improves function in the majority of patients. We present a case report of the treatment of bowel dysfunction with sacral nerve stimulation in a patient with a history of an imperforate anus. PRESENTATION OF CASE: A twenty year-old female with a history of imperforate anus at birth, repaired during infancy with anorectoplasty, presented with fecal incontinence and constipation...
2016: International Journal of Surgery Case Reports
Giovanni Ruggeri, Francesca Destro, Beatrice Randi, Mario Lima
PURPOSE: To report our 14 years experience with the laparoscopic-assisted anorectal pull-through (LAARP) for the treatment of male neonates with high imperforate anus. MATERIALS AND METHODS: We reviewed all medical charts of patients who underwent LAARP from January 2001 to January 2015 collecting information regarding demographic data, associated anomalies, type of fistula, pelvic floor muscles tropism, surgery (operative time, conversion to open technique, and complications), and follow-up...
May 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Saqib Hamid Qazi, Ahmad Vaqas Faruque, Muhammad Arif Mateen Khan, Umama Saleem
OBJECTIVE: To describe the management and functional outcome of anorectal malformations and associated anomalies according to Krickenbeck classification. STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: The Aga Khan University Hospital, Karachi, from January 2002 to December 2012. METHODOLOGY: Anorectal anomalies were classified according to Krickenbeck classification. Data was collected and proforma used regarding the primary disease associated anomalies, its management and functional outcome, according to Krickenbeck classification...
March 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Rahulkumar N Chavan, Bhargav Chikkala, Cinjini Das, Somak Biswas, Diptendra Kumar Sarkar, Sushil Kumar Pandey
This is a case report of 22-year-old girl admitted with abdominal distension, vomiting, and chronic constipation since birth. Abdomen was distended, and perineal examination revealed imperforate anus with vestibular fistula (ARM). So far worldwide very few cases have been reported about anorectal malformation presenting in adulthood, and thus extremely little data is available in the literature about an ideal management of anorectal malformation in adults. In our case in the treatment instead of conventional procedure of posterior sagittal anorectoplasty (PSARP) anal transposition was done and till two years after the definitive treatment during follow-up patient has been doing well with Kelly's score of six...
2015: Case Reports in Surgery
Algirdas Zalimas, Gintas Posiunas, Sigitas Strupas, Ramunas Raugalas, Juozas Raistenskis, Gilvydas Verkauskas
BACKGROUND: PELVIS is an acronym defining the association of perineal hemangioma, malformations of external genitalia, lipomyelomeningocele, vesicorenal abnormalities, imperforate anus and skin tag. Eleven cases have been reported according to the Orphanet data. Acronyms of LUMBAR and SACRAL syndrome have been used and most probably represent a spectrum of the same entity. Very little is known about the success and timing of cloacal reconstruction after the treatment of hemangioma. We present a variant of PELVIS syndrome and discuss the possibilities and optimal timing of surgical reconstruction...
October 8, 2015: BMC Pediatrics
Giorgia Totonelli, Vincenzo Davide Catania, Francesco Morini, Fabio Fusaro, Giovanni Mosiello, Barbara Daniela Iacobelli, Pietro Bagolan
PURPOSE: Anorectal malformations (ARM) can commonly occur in association with other congenital anomalies or as part of the combined anomaly. The present study aims to assess the outcome of patients with ARM and patients with ARM in VACTERL association. METHODS: A 12-year retrospective analysis of all patients treated at a single tertiary children's institution with a diagnosis of ARM. We identified and compared patients with ARM to those with ARM in VACTERL association (3 or more anomalies)...
September 2015: Pediatric Surgery International
Chen Wang, Long Li, Shuli Liu, Zheng Chen, Mei Diao, Xu Li, Guoliang Qiao, Wei Cheng
PURPOSE: This study aimed to evaluate the mid-term outcomes of single-stage modified anterior sagittal anorectoplasty (ASARP) for anorectal malformation with vestibular fistula. METHOD: Twenty-six patients with congenital imperforate anus and vestibular fistula underwent single-stage modified sphincter-saving ASARP between January 2008 and December 2012. The ages of the patients at the time of operation ranged from 1 month to 5.1 years. Standard ASARP procedure was modified to avoid the incision of the external sphincter complex...
September 2015: Pediatric Surgery International
Chen Wang, Long Li, Wei Cheng, Shuli Liu, Mei Diao, Xu Li, Guoliang Qiao, Zheng Zhang, Zheng Chen
PURPOSE: The aim of this study is to describe the surgical technique and evaluate midterm outcomes of the technique: laparoscopically assisted anorectoplasty (LAARP) and modified repair of urogenital sinus. METHOD: Seven patients with persistent cloaca underwent LAARP and modified repair of urogenital sinus between November 2005 and December 2010. The ages of the patients at the time of operation were 6 months to 15 years. Distal colostogram and micturating cystogram were performed preoperatively to identify the type of persistent cloaca...
July 2015: Journal of Pediatric Surgery
Jason P Sulkowski, Kristine M Nacion, Katherine J Deans, Peter C Minneci, Marc A Levitt, Hayat M Mousa, Seth A Alpert, Steven Teich
PURPOSE: This study describes our series of children with bowel and bladder dysfunction (BDD) treated with sacral nerve stimulation in order to begin to identify characteristics associated with better outcomes and guide future therapies. METHODS: Between May 2012 and February 2014, 29 patients were evaluated before and after sacral nerve stimulator (SNS) placement. A prospective data registry was developed that contains clinical information and patient-reported measures: Fecal Incontinence Qualify of Life Scale, Fecal Incontinence Severity Scale, PedsQL Gastrointestinal Symptom Scale, and Vancouver DES Symptom Scale...
October 2015: Journal of Pediatric Surgery
Nguyen Thanh Liem, Tran Anh Quynh
PURPOSE: To describe the surgical technique and outcomes of an one stage operation through modified posterior sagittal approach (PSAP) preserving the sphincter intact for anal agenesia with rectovestibula fistula. PATIENTS AND METHODS: 57 patients suffering from anal agenesis with rectovestibular fistula were operated by a one-stage operation through a modified PSAP preserving the external sphincter intact from 2002 to 2010. The operation was performed in one-stage through a posterior sagittal approach with three modifications: The external sphincter complex was not opened on the posterior side, the dissection was carried out outside the rectal pouch, the rectal pouch was not tapered and was pulled through the center of the external sphincter identified by muscle stimulator...
April 2015: Journal of Pediatric Surgery
Kristiina Kyrklund, Mikko P Pakarinen, Seppo Taskinen, Risto J Rintala
PURPOSE: Anterior anus (AA) is a low type of anorectal malformation that is seen exclusively in females, characterized by an essentially normal appearing anus in an abnormally anterior position. In AA, the anal canal is located mostly within the voluntary sphincter complex, differentiating it from a perineal fistula in females, and allowing for a nonoperative approach to management. This study aimed to characterize the controlled, long-term bowel functional outcomes and lower urinary tract symptoms (LUTS) in females with conservatively treated anterior anus...
July 2015: Journal of Pediatric Surgery
Maxime M van Meegdenburg, Erik Heineman, Paul M A Broens
BACKGROUND: Most patients with congenital anorectal malformation suffer from mild chronic constipation. To date, it is unclear why a subgroup of patients develops a persistent form of constipation. Because dyssynergic defecation is a common cause of constipation in the general population, we hypothesized that the severe form of constipation may be caused by dyssynergic defecation. METHODS: Retrospectively, we reviewed the medical records of 29 patients with anorectal malformations who had undergone anorectal function tests because of severe constipation...
August 2015: American Journal of Surgery
Kristiina Kyrklund, Mikko P Pakarinen, Seppo Taskinen, Risto J Rintala
PURPOSE: This study aimed to define the controlled outcomes into adulthood for bowel function and lower urinary tract symptoms (LUTS) for males treated for low ARMs with individualized, minimally invasive approaches that preserve the native continence mechanisms as far as possible. METHODS: This is a single-institution, cross-sectional study. All males treated for low ARMs with cutback anoplasty, incision of anocutaneous membrane or dilatations based on the exact type of each malformation between 1983 and 2006 were invited to answer a detailed questionnaire on bowel function and LUTS...
February 2015: International Journal of Colorectal Disease
Jie Mi, Dong Chen, Xiantan Ren, Huimin Jia, Hong Gao, Weilin Wang
UNLABELLED: Fecal incontinence and constipation after procedures for anorectal malformations (ARMs) are closely related to the maldevelopment of the striated muscle complex (SMC). Previous studies have demonstrated that myogenic regulatory factors (MRFs) play a significant role in muscle development. Wnt signal pathway is extremely important for MRFs regulation. This study was designed to investigate the spatiotemporal expression pattern of Wnt5a in SMC in ARMs rat embryos. MATERIALS AND METHODS: Anorectal malformation embryos were induced by ethylene thiourea on embryonic day 10 (E10)...
2014: International Journal of Clinical and Experimental Pathology
M D Levin
PURPOSE: To determine physiology of anorectal zone in norm and anorectal malformations (ARM) to optimize the surgical treatment. MATERIAL AND METHODS: Examination of 119 patients were selected, including 65 children without anorectal pathology and 54 patients with ARM. We performed barium enema with radiopaque marker placed near the anus. The manometric study of anorectal area was done using intubation tube with an inflatable cuff. RESULTS: The anal canal was detected in all of ARM patients with perineal and vestibular fistulas, as well as in most of the newborns without fistula...
2013: Experimental & Clinical Gastroenterology
Helena Borg, Marc Bachelard, Ulla Sillén
PURPOSE: Megarectosigmoid (MRS) is commonly seen in children with anorectal malformations (ARM) and contributes to the high incidence of constipation. Surgical resection has been advocated by some, whereas others propose intense bowel management as the treatment of choice. The aim of this study was to evaluate outcome of both bowel function and configuration after surgical or conservative treatment of MRS in ARM patients. MATERIALS AND METHODS: The study included 79 patients with ARM, excluding perineal fistula, (48 boys, 31 girls) from 1986 to 2007...
April 2014: Journal of Pediatric Surgery
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