[Appendicostomy for fecal incontinence in children and young people with myelomeningocele].
BACKGROUND
Myelomeningocele is a congenital condition where the central nervous system is affected; it may cause paresis in the bladder, colon and lower extremities. For the patients, faecal incontinence and obstipation are troublesome problems that are difficult to treat successfully.


METHODS
13 persons were included in the study. Faecal incontinence was the main indication for appendicostomy for antegrade irrigation. Five patients underwent laparoscopic surgery, the rest had an open laparotomy. The appendix was pulled out and anastomosed to the skin. In that way it made a channel through which a catheter could be introduced. Water could be instilled and the bowel emptied by irrigation.


CONCLUSIONS
No patient continued major soiling. Five leaked small quantities of faeces, in two there was some mucus discharge from the stoma, and one patient had problems with the irrigation. All patients were able to carry out the irrigation themselves, but a main problem was to motivate them to be responsible. This seemed to be correlated to the age of the child. Appendicostomy is therefore an effective method in the treatment of faecal soiling when all other conservative methods have failed.
Aase
Lene Jeanette Grasmo
LJ
Barneklinikken, Haukeland Universitetssykehus 5020 Bergen. lene.grasmo@student.uib.no
Sommerfelt
Kristian
K
Berstad
Tove
T
D000293:Adolescent; D000328:Adult; D001065:Appendix / Q000601:surgery*; D002431:Cecostomy; D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000601:surgery; D004766:Enterostomy / Q000009:adverse effects / Q000379:methods*; D005242:Fecal Incontinence / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008591:Meningomyelocele / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis; D012189:Retrospective Studies; D007507:Therapeutic Irrigation