Surgical Constipation Latest Topicshttps://pediatricsurgeryclub.com/forum/144-surgical-constipation/Surgical Constipation Latest Topicsen27/9/2026https://pediatricsurgeryclub.com/topic/3516-2792026/[size=6]A 4-year-old with a history of perineal anoplasty for a recto-perineal fistula presents with longstanding constipation. The anoplasty is well situated within the sphincter complex without a stricture. X-rays demonstrate copious stool throughout the colon. The most appropriate first step in bowel management for this patient is:

 

a Manual disimpaction

 

b Initiate weight-based daily senna

 

c Exam under anesthesia

 

d Start a psyllium-based fiber supplement

 

e Water-soluble contrast enema study[/size]

]]>3516Sat, 26 Sep 2026 14:23:47 +0000Constipation in children (surgical aspect)https://pediatricsurgeryclub.com/topic/1782-constipation-in-children-surgical-aspect/Any one want a high quality PDF of this chart, post in this thread, use a personalized picture as an avatar, and have three threads in the forums, I will send it to you in a private message

 

Edit: available without restrictions

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]]>1782Tue, 19 Jan 2021 18:03:10 +0000Management of severe functional constipation with failed medical managementhttps://pediatricsurgeryclub.com/topic/3345-management-of-severe-functional-constipation-with-failed-medical-management/quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns -

 

"When medical management fails to resolve constipation, patients with neurogenic or neuromuscular causes of chronic constipation, anorectal malformations, and patients with idiopathic CIC utilize daily enemas to achieve evacuation. Adherence to a regular bowel management program can achieve social continence for many of these patients, but as they grow older, it becomes more convenient for them to be able to manage enema administration independently. In these patients, ACE administration has been demonstrated to improve quality of life [9, 10]."

]]>3345Tue, 04 Feb 2025 08:51:05 +000012/11/2023https://pediatricsurgeryclub.com/topic/3035-12112023/[size=20px]A six-year old boy has a history of chronic constipation. He passed meconium within 24 hours of life and maintained regular defecation until age 3, but since then has required chronic laxatives and enemas to allow evacuation of stool. A contrast enema shows no evidence of a transition zone. High resolution anal manometry shows failure of internal anal sphincter relaxation with rectal distention. A full thickness rectal biopsy two cm proximal to the dentate line demonstrates normal ganglion cells. The next step in management should be:

 

A Colostomy

 

B Internal sphincter myectomy

 

C Transanal pullthrough

 

D Antegrade colonic enema (ACE) procedure

 

E Intrasphincteric botulinum toxin (Botox™) injection​[/size]

]]>3035Sun, 12 Nov 2023 11:36:52 +0000Parents education laxatives in pediatric constipationhttps://pediatricsurgeryclub.com/topic/2958-parents-education-laxatives-in-pediatric-constipation/see video link in second post

 

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]]>2958Sat, 02 Sep 2023 06:21:57 +0000Older child with severe constipation and abdominal distensionhttps://pediatricsurgeryclub.com/topic/2925-older-child-with-severe-constipation-and-abdominal-distension/see HQ PDF version from second post

 

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]]>2925Tue, 13 Jun 2023 18:44:22 +0000Laparoscopic segmental colectomy for functional constipationhttps://pediatricsurgeryclub.com/topic/2864-laparoscopic-segmental-colectomy-for-functional-constipation/see video link in second post

 

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]]>2864Fri, 17 Mar 2023 16:41:23 +0000Management of idiopathic constipationhttps://pediatricsurgeryclub.com/topic/2350-management-of-idiopathic-constipation/EBF3F1D8-B3A1-4DBA-957F-18D046577C95.jpeg.af03314ff981fd22a56086d1fe4e3238.jpeg]]>2350Sat, 14 Aug 2021 16:12:44 +0000Transanal Recto-colonic Resection for Idiopathic Constipationhttps://pediatricsurgeryclub.com/topic/1852-transanal-recto-colonic-resection-for-idiopathic-constipation/see video in second post

 

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]]>1852Fri, 05 Mar 2021 17:42:29 +0000Colonic resection for functional constipationhttps://pediatricsurgeryclub.com/topic/2666-colonic-resection-for-functional-constipation/C1A2BAE3-EF50-4EE7-987E-1B6417589582.jpg.1ddc3fc151f41b3148ff684f513e4619.jpg .]]>2666Mon, 21 Mar 2022 07:40:49 +000017/10/2021https://pediatricsurgeryclub.com/topic/2436-17102021/[size=20px]The best way to find out if the colon of the patient is clean after the administration of an enema is by:

 

a- measuring the amount of stool that came out

 

b- palpating the abdomen

 

c- rectal examination

 

d- taking an abdominal X-ray film

 

e- patient become more comfortable[/size]

]]>2436Sun, 17 Oct 2021 12:00:50 +0000Surgical constipation in Childrenhttps://pediatricsurgeryclub.com/topic/2383-surgical-constipation-in-children/see video link in second post

 

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]]>2383Tue, 24 Aug 2021 07:36:36 +0000Transanal rectosigmoidectomy for megarectum in idiopathic constipation animationhttps://pediatricsurgeryclub.com/topic/2035-transanal-rectosigmoidectomy-for-megarectum-in-idiopathic-constipation-animation/video link in second post

 

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]]>2035Sun, 09 May 2021 09:42:43 +0000constipated patienthttps://pediatricsurgeryclub.com/topic/1734-constipated-patient/[size=20px]A two-year old boy has a history of chronic constipation. He passed meconium within 24 hours of life. However, he has required chronic laxatives and enemas to allow evacuation of stool. A contrast enema shows no evidence of a transition zone. Anal manometry shows failure of internal anal sphincter relaxation after rectal distention. A full thickness rectal biopsy two cm proximal to the dentate line shows no ganglion cells with increased acetylcholinesterase activity while a biopsy 4.5 cm proximal to the dentate line shows ganglion cells. The child has a transient response to a botulinum toxin injection.

 

The next best step in management of this constipated patient is

 

A serial anal dilations.

 

B internal sphincter myectomy.

 

C endorectal pull through

 

D cecostomy for antegrade enemas

 

E initiate biofeedback therapy[/size]

]]>1734Sat, 26 Dec 2020 04:04:40 +0000a child with encopresishttps://pediatricsurgeryclub.com/topic/1472-a-child-with-encopresis/First one with correct answer with justification win.

 

[size=20px]A five-year old boy had an anorectal malformation repaired at birth. He was started on a bowel management program and had a very good response to dwell enemas, but tolerated them poorly and developed recurrent soiling and constipation when enemas were discontinued

 

Which of the following would be an appropriate next step for a child with encopresis?

 

A Colostomy

 

B Ileostomy

 

C Appendicostomy

 

D Sigmoid colectomy

 

E Proctectomy[/size]

]]>1472Mon, 21 Sep 2020 12:40:53 +0000