Cases Presented
Video Summary of Cases Presented
Dr. Antonio Gallardo from Mexico shared a challenging case involving a newborn with a megalourethra and rectoprostatic fistula, which led to a detailed discussion on surgical approaches and the importance of proper imaging studies. Dr. Adinda Bunga from Indonesia presented a case of a patient with a prolapsed colostomy, complex spinal dystrophy, and other anomalies, sparking a discussion on management strategies and the role of posterior sagittal anorectoplasty (PSARP). The meeting also included educational session on performing distal colostograms and managing specific conditions like anal duplications and rectoperineal fistulas. A third case discussed the diagnosis and surgical approaches to treating anal duplication. The fourth case a perineal fistula in a 17-month-old female patient with congenital right hip dislocation. Participants from various countries contributed to the discussions, sharing their experiences and expertise in treating these complex cases.
Case 1. Newborn Male Patient with Anorectal Malformation, Megalourethra, and Posterior Urethral Diverticulum
Antonio Gallardo, M.D.; Centro Colorrectal de Guadalajara, Guadalajara, Mexico
This was a complex case of a newborn with an anorectal malformation, megalourethra, and a posterior urethral diverticulum. The discussion focused on how to proceed with the posterior sagittal approach without a Foley catheter. Dr. Andrea Bischoff, moderator, suggested repairing the megalourethra first and passing the Foley catheter through the open area. Also recommended was repeating the distal colostogram to assess the bowel length.
Dr. Gallardo will present a follow up presentation that updates the progress of this patient.
Case 2. Infant Male Patient with Anorectal Malformation, Complex Spinal Dystrophy, and Recurrent Colostomy Complications
Adinda Bunga, M.D.; Pediatric Surgery Division, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
The case of a baby boy with anorectal malformation, complex spinal dystrophy, and other anomalies was presented. The discussion focused on the management of the recurrent colostomy complications, the necessity of a posterior sagittal anorectoplasty, and the type of stoma to be used. Moderator Dr. Andrea Bischoff emphasized the importance of a proper distal colostogram for surgical planning.
Distal Colostogram and Prolapse Repair Animation
Dr. Bischoff explained the technique for performing a distal colostogram and managing colotomy prolapse in patients with anorectal malformations. She emphasized the importance of obtaining a proper distal colostogram before considering surgery and explained the technique for repairing prolapsed colostomies. Questions about patient stimulation during surgery and the use of PSARP procedures were addressed. She discussed the choice of colostomy site, advocating for a descending colostomy to reduce prolapse due to its fixed position. Also, a technique for repairing prolapse by preserving bowel and using packing gauze or a Hager to locate and secure the bowel to the abdominal wall was described. It was clarified that patient stimulation during surgery does not affect bowel control prognosis and that a PSARP procedure is an option, though not mandatory, for patients with anorectal malformations.
Case 3. Female Patient 17 Years Old with Anal Duplication
Andrea Bischoff, M.D.; International Center for Colorectal and Urogenital Care, Children's Hospital Colorado, Aurora, CO
Dr. Andrea Bischoff presented two complex pediatric surgical cases. The first case involved a 17-year-old female with an anal duplication, which was successfully removed through a detailed surgical procedure.
Case 4. Female Patient 17 Months Old with Rectoperineal Fistula
Andrea Bischoff, M.D.; International Center for Colorectal and Urogenital Care, Children's Hospital Colorado, Aurora, CO
This case involved a 17-month-old female with multiple anomalies, including a rectoperineal fistula and absent vagina. A neovagina procedure was performed and the discussion focused on the importance of preserving mesorectal blood supply during the surgery. The discussion also covered the use of MRI and other diagnostic tools in pediatric surgical cases, emphasizing the need for individualized treatment approaches based on specific patient anatomy and symptoms.
February 2026 International Colorectal--Full Session Video