Megasigmoid: A Source of Pseudoincontinence in Children With Repaired Anorectal Malformations
Journal of Pediatric Surgery
February 1993 • Volume 28 • Number 2 • p199 to p203
Alberto Peña, M el Behery
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Three children with a history of anorectal malformation repairs were referred to the authors for evaluation and management of fecal incontinence. Their ages ranged from 5 to 7 years.
On examination, all the children had fecal impaction and localized dilatation of the rectosigmoid colon. Medical treatment was tried but failed to control the symptoms, and the patients frequently had to be hospitalized for disimpaction.
To correct this problem, the authors resected the dilated sigmoid colon, anastomosing the nondilated descending colon to the rectal ampulla, which was preserved to serve as a reservoir.
Postoperatively, constipation was cured in all patients. In addition the patients became fecally continent postoperatively, which was an unexpected bonus.
The authors believe that localized dilatation of the rectosigmoid should always be considered whenever a child is having intractable constipation after repair of an anorectal malformation and that sigmoid resection may be considered as a therapeutic alternative.
Segmental dilatation of the sigmoid colon may be a source of fecal pseudoincontinence and, therefore, should be ruled out when the surgeon is evaluating patients with fecal incontinence.
(J Pediatr Surg 1993 Feb;28(2):199-203)
Journal of Pediatric Surgery (Copyright ! 2002 by W.B. Saunders Company)
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