ABSTRACT
This chapter discusses the Bowel management. It describes the case of a teenage boy with an anorectal malformation. He underwent a posterior sagittal anorectoplasty (PSARP) for an anorectal malformation with no fistula as a baby following an initial colostomy, and then a colostomy closure. He required a redo PSARP with covering colostomy at the age of 6 years. The colostomy was reversed 8 weeks postoperatively and a cecostomy was placed. He recovered well from these operations and was under routine follow-up. His cecostomy was converted to a Malone appendicostomy electively. He performs intermittent urethral catheterization for a neurogenic bladder. He presents to clinic for follow-up and reports that he is having increasing problems with the Malone appendicostomy. Flushes took greater than 2 thours to complete and are associated with abdominal pain and cramping. He has intermittent soiling as well.
