ANTEGRADE COLONIC ENEMAS

Thirteen children aged 6-14 (mean 8) years in whom an antegrade coloni c enema procedure was performed were reviewed retrospectively. All pre sented with refractory constipation or faecal soiling over a 3-year pe riod. Nine of the children had previously undergone pull-through proce dures for Hirschsprung's disease or high anorectal malformations. Two were suffering from spina bifida and two from idiopathic functional co nstipation, The operation was performed through a right iliac fossa in cision, A catheterizable conduit was created. The appendix was brought out to the wound edge and made continent by intussuscepting the appen dix base into the caecum. When the appendix was absent or unusable, a caecal tube was formed. Five patients suffered minor morbidity, six re quired a further operative procedure and two eventually required a sig moid colostomy, However, the eventual outcome of a continent stoma was attained in 11 of the 13 children, all of whom would have been consid ered for sigmoid colostomy before introduction of the antegrade coloni c enema procedure.