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  • Cynthia M. Johnson, MA
Publication Type:



(Malone Procedure; Antegrade Colonic Enema Procedure)


An appendicostomy makes a path from the belly button to the large intestine. The path is created using the appendix.

The Appendix Can Be Used to Deliver Enemas.

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Reasons for Procedure

Enemas are normally given through the rectum. This surgery is done to make it easier to give an enema to a child. Enemas are fluids placed into the large intestine. The fluids help clean out the intestines when there is a problem. They may be needed in children with:

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia, such as wheezing or sore throat
  • Infection
  • Leaking
  • The need for repeat surgery

What to Expect

Problems To Look Out For

Call the doctor if your child is not getting better or has:

  • Signs of infection, such as fever or chills
  • Redness, swelling, bleeding, or discharge from the incision
  • Pain that cannot be controlled with medicine
  • Trouble using the tube
  • The tube falls out before your child has healed

If you think you have an emergency, call for medical help right away.





  • Appendicostomy (Malone procedure). Cincinnati Children’s website. Available at: https://www.cincinnatichildrens.org/service/c/colorectal/treatments/appendicostomy.
  • Appendicostomy or Malone procedure. Nationwide Children's Hospital website. Available at: https://www.nationwidechildrens.org/specialties/colorectal-and-pelvic-reconstruction-ccpr/services/surgical-repair/appendicostomy-or-malone-procedure.
  • Levitt, M.A., Soffer, S.Z., et al. Continent appendicostomy in the bowel management of fecally incontinent children. J Pediatr Surg, 1997; 32 (11): 1630-1633.
  • Management of constipation in children. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/management-of-constipation-in-children.


  • Marcin Chwistek, MD
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.