Appendicostomy(Malone Procedure; Antegrade Colonic Enema Procedure)
by
Cynthia M. Johnson, MA DefinitionAn appendicostomy makes a path from the belly button to the large intestine. The path is created using the appendix.
Reasons for ProcedureEnemas 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 ComplicationsProblems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
What to ExpectPrior to ProcedureThe surgical team may meet with you to talk about:
AnesthesiaGeneral anesthesia is used. Your child will be asleep. Description of the ProcedureA small cut will be made just below the belly button. The tip of the appendix will be opened. The opened end will attach to an opening in the belly button. If the appendix was removed, a new one will be made from the large intestine. A valve will then be placed. The valve allows the enema to flow one way. A tube will be passed through the belly button and valve. The tip of the tube will stay in the appendix. The end of the tube will stay outside of the belly button. The tube will be taped into place. It will stay in place for 2 to 4 weeks. How Long Will It Take?About 2 hours Will It Hurt?Pain is common in the first few days. Medicine and home care can help. Average Hospital StayThe usual length of stay is 1 to 5 days. If your child has any problems, they may need to stay longer. Post-procedure CareAt the Care CenterThe staff will:
At HomeIt will take 4 to 6 weeks for the site to fully heal. Physical activity will need to be limited during recovery. You may need to delay your child's return to normal activities. Call Your Child's DoctorCall the doctor if your child is not getting better or has:
If you think you have an emergency, call for medical help right away. RESOURCES:American Society of Colon and Rectal Surgeons https://www.fascrs.org Healthy Children—American Academy of Pediatrics https://www.healthychildren.org CANADIAN RESOURCES:Canadian Association of Gastroenterology https://www.cag-acg.org Sick Kids—The Hospital for Sick Children http://www.sickkids.ca References:Appendicostomy (Malone procedure). Cincinnati Children’s website. Available at:
https://www.cincinnatichildrens.org/service/c/colorectal/treatments/appendicostomy. Accessed December 2, 2020. Levitt MA, Soffer SZ, Péan A. 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. Accessed December 2, 2020. Taiwo A, Rangel SJ, Bischoff A, Peña A, Levitt MA. Laparoscopic-assisted Malone appendicostomy in the management of fecal incontinence in children. J Laparoendosc Adv Surg Tech A. 2011;21(5):455-459. Last reviewed September 2020 by
EBSCO Medical Review Board
Marcin Chwistek, MD Last Updated: 4/16/2021 | |
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