WASHINGTON, DC USA (UroToday.com) - For children with anorectal malformation (ARM), Dr. Shumyle Alam advocated a contrast enema with water-soluble contrast as part of their work-up.He indicated that it allows for an understanding of the anatomy, planning for resection, if required, and it provides an estimate of the volume needed for a Malone antegrade continence enema (MACE). The timing of treatment for fecal incontinence typically is at 4yrs of age. In those children with fecal incontinence, it is important to determine whether they have a dilated colon or not. Those with a dilated colon have hypomotility and will require a large volume concentrated enema for the MACE whereas those with nondilated colon have hypermotility and don’t respond well to enemas or the MACE. In these children a constipating diet, loperamide and fiber with a small enema may be useful.
Presented by Shumyle Alam, MD at the 59th Annual Meeting of the Society for Pediatric Urology during the American Urological Association (AUA) Annual Meeting - May 14 - 19, 2011 - Walter E. Washington Convention Center, Washington, DC USA
Reported for UroToday by Pamela I. Ellsworth, MD, Associate Professor Surgery (Urology), Alpert Medical School of Brown University.