Cases Presented
Video Summary of Cases Presented
The August 2025 International Colorectal Web Meeting Summary discussed various cases of anorectal malformations and their surgical management, including complex cases involving posterior cloaca, urinary continence, and the absence of reproductive organs. The participants shared techniques for surgical interventions, including ileostomy revision, urogenital mobilization, and the importance of accurate diagnosis through imaging and X-rays. The discussion concluded with recommendations for managing fistula cases in newborns and the use of different colostomy types, with an emphasis on preventing complications and maintaining urinary continence. The meeting focused on discussing various cases of anorectal malformations and their surgical management, including complex cases involving posterior cloaca, urinary continence, and the absence of reproductive organs. The participants shared techniques for surgical interventions, including ileostomy revision, urogenital mobilization, and the importance of accurate diagnosis through imaging and X-rays. The discussion concluded with recommendations for managing fistula cases in newborns and the use of different colostomy types, with an emphasis on preventing complications and maintaining urinary continence.
Case 1. Female Patient 14 Years Old with Stool Coming Through Vagina
Maria Dominguez, M.D., Hospital de Pediatria, Colorectal Department, Hospital Juan P. Garrahan, Buenos Aires, ArgentinaCcase of a 3-month-old female patient with a rare colonic duplication presenting as a rectovestibular fistula. After initial misdiagnosis, a detailed surgical repair was performed, involving resection of the vestibular fistula and connecting the duplicated sigmoid colon. The case highlighted the importance of thorough preoperative imaging and careful surgical planning in such rare anomalies.
Case 2. Female Patient 5 Years Old with ACTG2 Mutation
Andrea Bischoff, M.D.; International Center for Colorectal and Urogenital Care, Children's Hospital Colorado, Aurora, CO
A case of a 5-year-old female patient with an ACTG2 mutation and ileostomy prolapse was presented. The patient was treated by fixing the proximal bowel to the abdominal wall. Dr. Bischoff explained the technique and emphasized the importance of preventing stoma prolapse by using non-mobile portions of the bowel for stoma creation. Also addressed were questions about laparoscopic approaches and potential issues at stoma reversal, clarifying that the technique does not cause problems during reversal.
Case 3. Female Patient with Cloaca and Severe Cardiac Anomaly
Andrea Bischoff, M.D.; International Center for Colorectal and Urogenital Care, Children's Hospital Colorado, Aurora, CO
A case of a 5-year-old female patient with an ACTG2 mutation and ileostomy prolapse was presented. The patient was treated by fixing the proximal bowel to the abdominal wall. Dr. Bischoff explained the technique and emphasized the importance of preventing stoma prolapse by using non-mobile portions of the bowel for stoma creation. Also addressed were questions about laparoscopic approaches and potential issues at stoma reversal, clarifying that the technique does not cause problems during reversal.
Case 4. Newborn Male Patient with Trisomy 21 and Anorectal Malformation
Andrea Bischoff, M.D.; International Center for Colorectal and Urogenital Care, Children's Hospital Colorado, Aurora, CO
A case of an anorectal malformation without fistula in a patient with trisomy 21. The importance of using both AP and lateral X-rays for accurate diagnosis was stressed. In cases of discrepancy between the two views, the lateral measurement should be used. Also discussed was the role of voiding cystourethrogram in the diagnosis and management of anorectal malformations, noting that it is not part of the initial screening but may be necessary in cases of hydronephrosis. Dr. Bischoff concluded by highlighting the importance of meticulous and delicate surgical techniques in separating structures during operations for anorectal malformations.
Patient Case Discussion