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Case # 3
AlbertoPeñaJune21,2018.
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• 50yo malepatientbornwithananorectalmalformation
• Colostomyatbirth• Pull-through(nooperativereports)• Colostomywasneverclosed(justonestoma)
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Whatwouldyouliketodo?1) Protocolofanaldilation2) Proximalcolostogram andrectalcontrast
enema3) SacralX-rayAPandlateral4) Nothing5) Idon’tknow
Onphysicalexam– analstricture
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• Patientunderwentredoanoplasty,willfollowtheprotocolofanaldilationandcomebackforcolostomyclosure
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Case # 4
AndreaBischoffJune21,2018.
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• Terminalstoma• “Bornwithoutacolon”• Endstagerenaldisease,currentlyonhemodialysis,waitlistforkidneytransplant
• Hewantstoknowifheisacandidateforastomapullthrough
26yo,male,born with ananorectal malformation
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1) Injectionofcontrastmaterialthroughthestoma
2) SacralX-rayAPandlateral3) UpperGIwithsmallbowelfollowthrough4) PelvicMRI5) PSARP6) Idon’tknow
Whatwouldyouliketodo?
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Nocolon,noanus – whatdoyou recommend?
1)Ileo-analpullthrough2)Permanent stoma3)Ileal pullthrough with Jpouch4)Idon’t know
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Patients that arebornwithout the anus cannot
have an ileo-analpullthrough.