29. National Pediatric Surgery Congress and 27. National Congress of The Egyptian Pediatric Surgical Association

Background/Purpose: Constipation in children is considered when stool frequency is less than 3 thimes per week. Encopresis represents 80-90% of children with fecal incontinence. Operative strategy for management of encopresis ranges from resectional surgry to myotomy. The objective of the study was to evaluate the efficacy of non reversed appendicostomy without antireflux mechanism for management of encopresis in children.

• Material & Methods: The study included 35 patients with sever idiopathic constipation and encopresis with failure of conservative measures.. Theirmedian age at the time of operation was 5 years (2.5-9) years with the male prepondrance 60% of the series (21 cases). Diagnostic evaluation included contrast enema and rectal bunch biopsy. They were subjected to non-reversed appendicostomy without anti-reflux procedures.

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• Results:Encopresis and constipation resolved within one-three months of ACE washouts. The mean follow up period was 23 months (11 to 34 months), during which there was no fecal impaction or episodes of soiling.
• The mean follow up period was 23 months (11 to 34 months), during which there was no fecal impaction or episodes of soiling. The incidence of complication was 22.8% and included stomal leak, stricture, retraction and granulation tissue formation. False passage during dilatation occurred in one case. Antegrad continent enema effectively controlled constipation and encopresis.

Conclusion: Non-reversed appendicostomy without antireflux mechanism is safe and rapid with minimal incidence of leakage. Constipation and encopresis was effectively controlled with this simple procedure.

Index Word: Constipation, encopresis, antegrade continent enema. 

Background/Purpose: Constipation in children is considered when stool frequency is less than 3 thimes per week. Encopresis represents 80-90% of children with fecal incontinence. Operative strategy for management of encopresis ranges from resectional surgry to myotomy. The objective of the study was to evaluate the efficacy of non reversed appendicostomy without antireflux mechanism for management of encopresis in children.

• Material & Methods: The study included 35 patients with sever idiopathic constipation and encopresis with failure of conservative measures.. Theirmedian age at the time of operation was 5 years (2.5-9) years with the male prepondrance 60% of the series (21 cases). Diagnostic evaluation included contrast enema and rectal bunch biopsy. They were subjected to non-reversed appendicostomy without anti-reflux procedures.

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• Results:Encopresis and constipation resolved within one-three months of ACE washouts. The mean follow up period was 23 months (11 to 34 months), during which there was no fecal impaction or episodes of soiling.
• The mean follow up period was 23 months (11 to 34 months), during which there was no fecal impaction or episodes of soiling. The incidence of complication was 22.8% and included stomal leak, stricture, retraction and granulation tissue formation. False passage during dilatation occurred in one case. Antegrad continent enema effectively controlled constipation and encopresis.

Conclusion: Non-reversed appendicostomy without antireflux mechanism is safe and rapid with minimal incidence of leakage. Constipation and encopresis was effectively controlled with this simple procedure.

Index Word: Constipation, encopresis, antegrade continent enema.