ABSTRACT
INTRODUCTION: An antegrade colonic enema (ACE) via an appendicostomy has been shown to be effective in the management of functional bowel problems. In cases with a missing appendix, a neoappendicostomy may be considered. MATERIALS AND METHODS: A retrospective review of clinical outcomes in children who underwent ileal neoappendicostomy for ACE. Medical records were reviewed for data on demography, intra- and postoperative complications. A follow-up questionnaire on stoma problems, ACE-related problems, bowel function, patient satisfaction, well-being, and effect on daily activities was performed. RESULTS: Ten patients were included at an average age of 10.6 years at surgery. In half of the patients, minor postoperative complications (Clavien-Dindo grade 2 or less) were found. Nine patients answered the questionnaire with a mean follow-up of 57 months. Despite complaints of stomal leakage, difficulties with catheterization, and pain during irrigation, they reported a high grade of satisfaction, improvements in well-being, and bowel function and the achievement of continence. CONCLUSION: Ileal neoappendicostomy may be an alternative to ACE in children with severe and medically intractable constipation and or/and fecal incontinence where the appendix is missing or not available.
Subject(s)
Fecal Incontinence/surgery , Ileum/surgery , Adolescent , Anastomosis, Surgical/methods , Appendix/abnormalities , Child , Child, Preschool , Constipation/surgery , Enema/methods , Humans , Patient Satisfaction , Retrospective Studies , Surgical Stomas/adverse effects , Surveys and QuestionnairesABSTRACT
The purpose of this report is to describe a case of appendicitis in the left iliac fossa. Clinical presentation involved pain in the right iliac fossa with all classical signs of appendicitis. Anomalous location of the appendix was suspected on the basis of a special clinical feature and the patient's family history. Confirmation was achieved by colic contrast enema before surgical treatment.
Subject(s)
Appendicitis/diagnosis , Appendicitis/pathology , Appendix/abnormalities , Abdominal Pain , Adult , Appendectomy , Appendicitis/surgery , Appendix/diagnostic imaging , Colon/diagnostic imaging , Contrast Media , Enema , Humans , Male , RadiographyABSTRACT
Anomalies of the appendix are rare and are usually found in the adult population as an incidental finding during the course of surgery. We describe the appearances of a Type B duplicated appendix demonstrated on a barium enema for the first time. A review of the literature is presented with a discussion of different forms of duplicated appendices and the clinical significance of this finding.