Case # 3

AlbertoPeñaJune21,2018.

• 50yo malepatientbornwithananorectalmalformation

• Colostomyatbirth• Pull-through(nooperativereports)• Colostomywasneverclosed(justonestoma)

Whatwouldyouliketodo?1) Protocolofanaldilation2) Proximalcolostogram andrectalcontrast

enema3) SacralX-rayAPandlateral4) Nothing5) Idon’tknow

Onphysicalexam– analstricture

• Patientunderwentredoanoplasty,willfollowtheprotocolofanaldilationandcomebackforcolostomyclosure

Case # 4

AndreaBischoffJune21,2018.

• Terminalstoma• “Bornwithoutacolon”• Endstagerenaldisease,currentlyonhemodialysis,waitlistforkidneytransplant

• Hewantstoknowifheisacandidateforastomapullthrough

26yo,male,born with ananorectal malformation

1) Injectionofcontrastmaterialthroughthestoma

2) SacralX-rayAPandlateral3) UpperGIwithsmallbowelfollowthrough4) PelvicMRI5) PSARP6) Idon’tknow

Whatwouldyouliketodo?

Nocolon,noanus – whatdoyou recommend?

1)Ileo-analpullthrough2)Permanent stoma3)Ileal pullthrough with Jpouch4)Idon’t know

Patients that arebornwithout the anus cannot

have an ileo-analpullthrough.