title: A novel colonoscopic approach for the management of a Malone antegrade continence enema channel, which cannot be catheterized in the immediate postoperative period: a case report.
abstract: Early Malone antegrade continence enema (MACE) complications are rare, but can be devastating, particularly if they involve loss of the channel. Management of these complications is not well described. We report on a patient who had her MACE channel successfully salvaged in the immediate postoperative period using a colonoscopic retrograde wire and catheter placement after failing antegrade percutaneous endoscopic management. To our knowledge, this is the first report of a novel, colonoscopic, minimally invasive technique of managing select MACE channels, which cannot be otherwise recatheterized. We also review the management of postoperative MACE complications.
authors.affiliation: Division of Pediatric Urology, Riley Hospital for Children at Indiana University Health, Indianapolis, IN. Electronic address: szymanko@iupui.edu.
authors.forename: Konrad M
authors.initials: KM
authors.lastname: Szymanski
authors.affiliation: Division of Pediatric Urology, Riley Hospital for Children at Indiana University Health, Indianapolis, IN.
authors.forename: Alison
authors.initials: A
authors.lastname: Keenan
authors.affiliation: Division of Pediatric Urology, Riley Hospital for Children at Indiana University Health, Indianapolis, IN.
authors.forename: Mark P
authors.initials: MP
authors.lastname: Cain
authors.affiliation: Department of Pediatrics, Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Indiana University School of Medicine, Indianapolis, IN.
authors.forename: Shamaila
authors.initials: S
authors.lastname: Waseem
authors.affiliation: Division of Pediatric Urology, Riley Hospital for Children at Indiana University Health, Indianapolis, IN.
authors.forename: Martin
authors.initials: M
authors.lastname: Kaefer
mesh_terms: D002648:Child; D003113:Colonoscopy / Q000379:methods*; D003248:Constipation / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D013505:Digestive System Surgical Procedures / Q000379:methods; D004733:Enema / Q000379:methods*; D005242:Fecal Incontinence / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008591:Meningomyelocele / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011182:Postoperative Care / Q000379:methods; D018570:Risk Assessment; D016896:Treatment Outcome