Appendicostomy
Procedure
(Malone Procedure; Antegrade Colonic Enema Procedure)
Definition
An appendicostomy makes a path from the belly button to the large intestine. The path is created using the appendix.
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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:
- Spina bifida
- Hirschsprung disease
- Spinal injuries
- Constipation
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.
American Society of Colon and Rectal Surgeons
Healthy Children—American Academy of Pediatrics
CANADIAN RESOURCES:
Canadian Association of Gastroenterology
Sick Kids—The Hospital for Sick Children
American Society of Colon and Rectal Surgeons
Healthy Children—American Academy of Pediatrics
CANADIAN RESOURCES:
Canadian Association of Gastroenterology
Sick Kids—The Hospital for Sick Children
References
- 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.
Contributors
- Marcin Chwistek, MD
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