Percutaneous endoscopic colostomy of the left colon: a new technique for management of intractable constipation in children

Gastrointestinal Endoscopy
David J RawatJohn M Fell

Abstract

The antegrade colonic enema is accepted as effective for management of intractable constipation in children when conventional bowel management has failed. This study describes experience with a new, minimally invasive technique, the distal antegrade colonic enema, which involves percutaneous endoscopic colostomy of the left colon. Fifteen children with refractory constipation and soiling who had radiographic evidence of megarectum and/or distal colonic delay were selected for the procedure. The junction of the descending and the sigmoid colon was identified colonoscopically, and the percutaneous endoscopic colostomy tube, through which antegrade distal colonic enema are administered, was inserted. Fourteen children underwent distal percutaneous endoscopic colostomy insertion. The median time required for the procedure was 30 minutes (20-50 minutes). Excluding one child (technical difficulties with percutaneous endoscopic colostomy placement), median post-procedural hospital stay was 4 days (2-27 days). Thirteen children were no longer soiling, and improvement in quality of life was reported at 2 months' follow-up. At 6 months' follow-up, 90% of children were clean during intervals between enemas. All children evaluated at 12 mo...Continue Reading

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Citations

Apr 15, 2008·Pediatric Surgery International·Chandrasen Kumar SinhaHarry C Ward
Apr 25, 2009·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Russell MullenSatheesh Yalamarthi
Apr 1, 2007·Neuromodulation : Journal of the International Neuromodulation Society·Cristian Sevcencu
Apr 25, 2014·Gastroenterology Report·Andrew P Zbar
Aug 26, 2014·Gastrointestinal Endoscopy·Brooks D CashAmy Wang
Feb 12, 2011·Journal of Pediatric Urology·S C BlackburnM Haddad
Aug 7, 2007·Journal of Vascular and Interventional Radiology : JVIR·Sergio SierreJulieta Solana
May 29, 2007·Gastrointestinal Endoscopy·Simon CowlamYan Yiannakou
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Jul 27, 2007·The British Journal of Surgery·W BarazaP Hurlstone
Mar 11, 2016·Current Opinion in Pediatrics·Richard J WoodMarc A Levitt
May 1, 2021·Journal of Clinical Medicine·Giovanni MosielloMarc A Benninga

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