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Ileostomy management children

Kristy L Rialon, Eileen Crowley, Natashia M Seemann, Aodhnait S Fahy, Aleixo Muise, Jacob C Langer
PURPOSE: The timing of J-pouch surgery following colectomy for children with very early-onset colitis is controversial, with some advocating early reconstruction and others delaying reconstruction because of fear that the colitis may be owing to Crohn's disease (CD). We sought to determine the long-term incidence of CD in this population and whether there may be clinical features that predict the risk of CD. METHODS: Children with noninfectious colitis diagnosed prior to age 10, who underwent subtotal colectomy and ileostomy from 2000 to 2015, were reviewed...
May 2018: Journal of Pediatric Surgery
Harissou Adamou, Oumarou Habou, Ibrahim Amadou Magagi, Ousseini Adakal, Amadou Magagi, Maazou Halidou, Rachid Sani
BACKGROUND: Intestinal ostomies are common surgical procedures performed in visceral surgery as part of management for several gastrointestinal diseases. This study aims to report the socio-demographic characteristics, indications and prognosis of intestinal ostomies in low-income country. METHODS: This was a 4-year retrospective study (January 2013 to December 2016) at Zinder National Hospital (Niger). All patients with a digestive ostomy on an ileum or colic segment were included in the study...
November 15, 2017: World Journal of Surgery
Rizwan Ahmad Khan, Shagufta Wahab, Imran Ghani
INTRODUCTION: Abdominal tuberculosis is fairly common in children. The most common clinical presentation is bowel obstruction. Depending upon the presentation, the intestinal obstruction can be either managed conservatively or by operative intervention. There are various options in patients who undergo operative treatment. This study was undertaken to analyze the results of operative intervention with and without ileostomy. MATERIALS AND METHODS: This is a retrospective study carried out over a period of 10 years on 32 children who were operated for small bowel obstruction due to abdominal tuberculosis...
November 2017: Pediatric Surgery International
Rajmohan Dharmaraj, Melodee Nugent, Pippa Simpson, Marjorie Arca, Bhaskar Gurram, Steven Werlin
BACKGROUND: Temporary fecal diversion by means of an ileostomy or colostomy has been used in the surgical management of refractory colonic and perianal Crohn disease (CD). The aims of our study were to evaluate the outcomes after fecal diversion in pediatric patients with colonic and perianal CD. METHODS: The records of patients who underwent fecal diversion for colonic and perianal CD at Children's Hospital of Wisconsin between July 2000 and June 2014 were reviewed retrospectively...
March 2018: Journal of Pediatric Surgery
Miriam García Gonzalez, Isabel Casal Beloy, Alba Gómez Dovigo, Lorena Miguez Fortes, Teresa Dargallo Carbonell, Salvador Pita-Fernández, Jesús Caramés Bouzán
Necrotizing enterocolitis (NEC) is the most common surgical emergency in neonatal intensive care units, and patients who require surgery have high mortality and morbidity rates. The utility of negative pressure in the management of adults with complicated abdominal wounds has been documented, but there are few reports describing the use of negative pressure wound therapy (NPWT) in children or following neonatal surgery. The case of a 6 day old, 5-weeks premature neonate with NEC is presented. An exploratory midline laparotomy was performed on day 3 of life owing to rectal bleeding and abdominal distension that did not respond to gastric decompression, bowel rest, and intravenous antibiotics...
June 2017: Ostomy/wound Management
Yew-Wei Tan, Osvaldo Borrelli, Keith Lindley, Nikhil Thapar, Joe Curry
PURPOSE: To report outcomes of children with constipation refractory to medical management and manometrically proven distal colonic dysmotility, managed with rectosigmoidectomy followed by Duhamel operation (Duhamel). METHODS: Children who underwent a Duhamel from 2009 onwards for intractable constipation and left colonic dysmotility were retrospectively reviewed. The primary end point was resolution of constipation, and secondary end point was postoperative complications...
August 2017: Pediatric Surgery International
Elizabeth C Maxwell, Noor Dawany, Robert N Baldassano, Petar Mamula, Peter Mattei, Lindsey Albenberg, Judith R Kelsen
OBJECTIVES: Diverting ileostomy is used as a temporizing therapy in patients with perianal Crohn disease; however, little data exist regarding its use for colonic disease. The primary aim of the present study was to determine the role of diversion in severe refractory colonic inflammatory bowel disease (IBD) in a pediatric population. METHODS: Retrospective study of patients who underwent diverting ileostomy at The Children's Hospital of Philadelphia from 2000 to 2014 for the management of severe, refractory colonic IBD...
September 2017: Journal of Pediatric Gastroenterology and Nutrition
S Kuizenga-Wessel, I J N Koppen, L W Zwager, C Di Lorenzo, J R de Jong, M A Benninga
BACKGROUND: Children with intractable functional constipation (FC) may eventually require surgery. However, guidelines regarding the surgical management of children with intractable FC are lacking. The aim of this study was to describe the surgical management of FC in children. METHODS: A retrospective chart review was performed of children with FC (according to the Rome III criteria) who underwent ileostomy, colostomy or (sub)total colectomy at a tertiary hospital...
May 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Natashia M Seemann, Sebastian K King, Abdul Elkadri, Thomas Walters, Joel Fish, Jacob C Langer
BACKGROUND/PURPOSE: Perianal Crohn's disease (PCD) can affect both quality of life and psychological wellbeing. A subset of pediatric patients with complex PCD require surgical intervention, although appropriate timing and treatment regimens remain unclear. This study aimed to describe a large pediatric cohort in a tertiary center to determine the range of surgical management in children with complex PCD. METHODS: A retrospective review of children requiring operative intervention for PCD over 13 years (2002-2014) was performed...
December 2016: Journal of Pediatric Surgery
Julie Galea, Katherine M Burnand, Fiona L Dawson, Chandrasen K Sinha, Dean Rex, Bruce O Okoye
Aim Pneumatosis intestinalis (PI) is a condition in which multiple gas-filled cysts form within the wall of the gastrointestinal tract in either the subserosa or submucosa. The presence of pneumoperitoneum in the presence of PI can present a therapeutic dilemma. The aim of our study was to review our experience and management of this condition. Methods A single-center retrospective study of consecutive children (> 1 year) presenting with a pneumoperitoneum and evidence of PI (2009-2015). Demographics, case notes, microbiology, and imaging were reviewed...
February 2017: European Journal of Pediatric Surgery
Rebecca West, Dipanker Dass, Santosh Mordekar, David Campbell, Richard Lindley
This case series describes our experience in managing 4 children with complex neurodisability, feed intolerance, and pneumatosis coli. In all of the 4 patients, symptoms and feed tolerance were substantially improved by the formation of a laparoscopically assisted defunctioning ileostomy. We describe our present management strategy and believe this is a promising treatment for those patients who can reduce long-term dependence on parenteral nutrition, although we acknowledge that there is a long-term risk of disuse colitits in the defunctioned bowel...
February 2017: Journal of Pediatric Gastroenterology and Nutrition
Nada Gawad, Dina El Demellawy, Carolyn Wayne, Juan Bass, Ahmed Nasr
BACKGROUND: Postoperative complication from the ileoanal anastomosis (J-pouch) procedure for surgical management of refractory ulcerative colitis (UC) increases the risk of pouch dysfunction. The purpose of this study was to determine if histologic inflammatory activity of the rectal margin is an independent predictor of complication after controlling for other variables. METHODS: A retrospective chart review was performed to identify all pediatric patients with UC who underwent a J-pouch procedure between 1995 and 2014...
May 2016: Journal of Pediatric Surgery
Khaled El-Asmar, Ehab El-Shafei, Mohammed Abdel-Latif, Amr AbouZeid, Mosad El-Behery
BACKGROUND: Inflammatory bowel disease (IBD) is increasingly encountered in children. Early disease is associated with higher complication rate with increased incidence of surgical intervention. PATIENTS AND METHODS: From January 2010 to June 2015, 25 patients in the pediatric and adolescent age groups with IBD underwent surgical intervention in our center. They were classified into two groups. Group I included 15 patients with ulcerative colitis where 5 cases had left colon disease underwent left colectomy, while 10 cases had pancolonic disease underwent total colectomy and anal mucosectomy with ileo-anal or ileal pouch-anal anastomosis with covering ileostomy...
February 2016: International Journal of Colorectal Disease
Vaibhav Gupta, Augusto Zani, Paul Jackson, Shailinder Singh
A 7-year-old boy presented in septic shock secondary to appendicitis with generalised peritonitis. Following crystalloid resuscitation, he underwent surgery. Faecopurulent contamination and free air were found. This was secondary to a perforated and gangrenous appendix, multiple large and small bowel segments with perforations, patches of necrosis, interspersed with healthy bowel and segments of questionable viability. There was also a perforated duodenal ulcer. Necrotic segments were resected using a 'clip-and-drop' technique to shorten operative duration and guide resection to preserve bowel length...
June 8, 2015: BMJ Case Reports
Basavaraj Kerur, Kanchan Kantekure, Silvana Bonilla, Bruce Orkin, Alejandro F Flores
BACKGROUND: Chronic intractable constipation (CIC) is a debilitating disease that is challenging to manage. Treatment options in children include medications, enemas, and surgical management in selected cases. METHOD: We reviewed medical records of pediatric patients diagnosed as having CIC at Tufts Medical Center from 2005 to 2012. Demographic variables, diagnostic procedures, and medical and surgical outcomes were collected. Clinical outcome was defined using the Rome III criteria...
December 2014: Journal of Pediatric Gastroenterology and Nutrition
Alba Sánchez-Galán, Ane M Andres, Beatriz Fernández-Caamaño, Alejandra Vilanova, Eva Dominguez, Ruben Ortiz, Gerardo Prieto, Manuel Lopez-Santamaria, J A Tovar
Ulcerative ileitis (UI) after restorative proctocolectomy (RPC) and ileoanal pullthrough procedure (IAPP) is a rare condition described as inflammation of the terminal ileum proximal to the anastomosis. It is mostly observed in ulcerative colitis (UC) and is designated as prepouch ileitis; sometimes with pouchitis, but not necessarily all the time. Its incidence in adults is less than 5%, but the information in children is limited. Pathogenesis is unknown, it has been considered as a disease by itself, independently on the underlying disease...
February 2015: European Journal of Pediatric Surgery
Gianluca Pellino, Guido Sciaudone, Erasmo Miele, Giuseppe Candilio, Gilda Serena De Fatico, Gabriele Riegler, Annamaria Staiano, Silvestro Canonico, Francesco Selvaggi
Background. Restorative proctocolectomy with ileal-pouch anal anastomosis (IPAA) has some peculiarities in paediatric ulcerative colitis (UC). Aims. The primary aim was to compare the bowel function of patients undergoing IPAA between those operated on in childhood and adulthood. The secondary aim was to compare the quality of life (QoL) and outcomes for children between medical and surgical therapies. Method. Children undergoing IPAA were compared with adult patients undergoing IPAA between 2007 and 2012. Function was assessed 1 year after ileostomy closure...
2014: Gastroenterology Research and Practice
Raelene D Kennedy, D Dean Potter, Christopher R Moir, Mounif El-Youssef
PURPOSE: Understanding the natural history of Familial Adenomatous Polyposis (FAP) will guide screening and aid clinical management. METHODS: Patients with FAP, age ≤20years presenting between 1987 and 2011, were reviewed for presentation, diagnosis, extraintestinal manifestations, polyp burden, family history, histology, gene mutation, surgical intervention, and outcome. RESULTS: One hundred sixty-three FAP patients were identified. Diagnosis was made by colonoscopy (69%) or genetic screening (25%) at mean age of 12...
January 2014: Journal of Pediatric Surgery
Simon Blackburn, Phillip Corbett, D Mervyn Griffiths, David Burge, R Mark Beattie, Michael Stanton
PURPOSE: Total colonic aganglionosis (TCA) is a rare condition, which is challenging to manage. Outcome data are sparse. We aimed to review the demographics, treatment, and outcomes of TCA in our center. PATIENTS AND METHODS: A retrospective case note review of 15 years from a single center was undertaken. RESULTS: A total of nine patients (five male) were managed. Gestational age at birth was 39 weeks (range, 32.5-41 weeks). All patients were referred with distal intestinal obstruction at a median of day 2 (range, 1-6 days) of life...
December 2014: European Journal of Pediatric Surgery
Christina B Ching, Heidi A Stephany, Trisha M Juliano, Douglass B Clayton, Stacy T Tanaka, John C Thomas, Mark C Adams, John W Brock, John C Pope
PURPOSE: Ileovesicostomy is a reconstructive option in complex urological cases but pediatric specific outcomes are lacking. We report our results with pediatric ileovesicostomy. MATERIALS AND METHODS: We retrospectively evaluated patients younger than 18 years undergoing incontinent ileovesicostomy at Vanderbilt University. History, urinary tract management and operative course were reviewed in the electronic medical record. Particular attention was given to immediate and long-term postoperative complications...
February 2014: Journal of Urology
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