Brief Article
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World J Radiol. Dec 28, 2010; 2(12): 463-467
Published online Dec 28, 2010. doi: 10.4329/wjr.v2.i12.463
Percutaneous cecostomy in the management of organic fecal incontinence in children
Ragab Hani Donkol, Ahmed Al-Nammi
Ragab Hani Donkol, Department of Radiology, Faculty of Medicine, Cairo University, Egypt Aseer Central Hospital, PO Box 34, 31911, Abha, Saudi Arabia
Ragab Hani Donkol, Department of Radiology, Faculty of Medicine, Cairo University, Cairo 81, Egypt
Ahmed Al-Nammi, Department of Radiology, Aseer Central Hospital, Saudi Arabia, PO Box 34, 31911, Abha, Saudi Arabia
Author contributions: Donkol RH contributed to the design of the study, analysis of data, manuscript writing, including drafting the article, and revising it critically for important intellectual content; Al-Nammi A shared in manuscript writing and performing the procedures.
Correspondence to: Ragab Hani Donkol, Professor, Department of Radiology, Faculty of Medicine, Cairo University, Egypt Aseer Central Hospital, PO Box 34, 31911, Abha, Saudi Arabia. donkol@gawab.com
Telephone: +966-7-2201169 Fax: +966-7-2248092
Received: September 29, 2010
Revised: November 20, 2010
Accepted: November 25, 2010
Published online: December 28, 2010
Abstract

AIM: To assess the effectiveness and safety of imaging-guided percutaneous cecostomy in the management of pediatric patients with organic fecal incontinence.

METHODS: Twenty three cecostomies were performed on 21 children with organic fecal incontinence (13 males, 8 females), aged from 5 to 16 years (mean 9.5 years). Thirteen patients had neurogenic fecal incontinence and 8 patients had anorectal anomalies. Procedures were performed under general anesthesia and fluoroscopic guidance. Effectiveness and complication data were obtained for at least 1 year after the procedure.

RESULTS: Cecostomy was successful in 20 patients (primary technical success rate 95%). Cecostomy failed in one patient due to tube breakage (secondary technical success rate 100%). The tubes were in situ for an average of 18 mo (range 12-23 mo). Eighteen patients (87%) expressed satisfaction with the procedures. Resolution of soiling was achieved in all patients with neurogenic fecal incontinence (100%) and in 5 of 8 patients with anorectal anomalies (62.5%). Eleven patients (52%) experienced minor problems. No major complications were noted.

CONCLUSION: Percutaneous cecostomy improves the quality of life in children with organic fecal incontinence. A satisfactory outcome is more prevalent in patients with neurogenic fecal incontinence than anorectal anomalies.

Keywords: Cecostomy; Fecal incontinence; Interventional radiology; Pediatric radiology