Cases Presented
Video Summary of Cases Presented
The October 2025 International Colorectal Web Meeting featured four pediatric surgical case presentations focusing on surgical management of pediatric gastrointestinal conditions, including discussions about Hirschsprung disease, constipation, and fistula cases. The team deliberated on diagnostic approaches and surgical procedures, with particular attention to individual patient circumstances and surgeon experience. The presentations highlighted various treatment strategies
Case 1. Hirschsprung Disease in an Adolescent Male
Ana Cristina Castellanos Pérez, M.D.; National Institute of Pediatrics, Mexico City, Mexico
This was a complex case of Hirschsprung disease in an adolescent male. Hirschsprung disease in an adolescent patient. The surgical team discussed the diagnostic process, surgical management, and postoperative care. The team performed a pull-through procedure with a protective ileostomy, which was closed 3 weeks later. Moderators expressed doubt about the diagnosis, suggesting that idiopathic constipation might be a more likely explanation, and emphasized that not every case of constipation requires a biopsy. Also highlighted was the importance of considering social factors in treatment decisions.
Case 2. Surgical Management of Hirschsprung Disease in Male Patient
Jorge Colin-Garnica, M.D., International Center for Colorectal and Urogenital Care, Children's Hospital Colorado, Aurora, CO
Presented was a complex case of a patient born with Hirschsprung disease who underwent multiple surgeries from birth through 2025. The patient experienced multiple episodes of severe constipation, rectal perforations, and required multiple abdominal operations including a Swenson type ileorectal pull-through with an ileostomy. Despite the extensive surgical history, by October 2023 the patient was asymptomatic and maintained on loperamide, with no accidents or soiling.
Case 3. Newborn with Post-natal Diagnosis of Rectovestibular Fistula
Andrea Bischoff, M.D.; International Center for Colorectal and Urogenital Care, Children's Hospital Colorado, Aurora, CO
This case a study of a newborn with a recto-vestibular fistula and a bowel management case for a nonverbal autistic patient. The discussion covered diagnostic studies, surgical approaches, and timing of operations, with Alberto emphasizing that while there's no one-size-fits-all answer, early repair is preferred when feasible.
Case 4. Bowel Management of a Nonverbal Autistic Patient Suffering from Constipation and Fecal Incontinence
Andrea Bischoff, M.D.; International Center for Colorectal and Urogenital Care, Children's Hospital Colorado, Aurora, CO
This was a bowel management case that demonstrated how successful treatment could significantly improve quality of life for both the nonverbal patient and family, with the presenter highlighting the importance of engaging families, particularly for nonverbal patients. The conversation ended with a reminder of the global participation from pediatric surgeons across multiple countries.
Patient Case Discussion