Cases Presented
Video Summary of Cases Presented
The September 2025 International Colorectal Web Meeting featured three pediatric surgical case presentations. Dr. María Zornoza from Mexico presented a case involving a covered cloacal exstrophy. Moderator Dr. Andrea Bischoff presented two cases covering two complex anorectal malformation cases.
Case 1. Female Patient 3 Months with Stool Coming through Vagina
Andrea Bischoff, M.D.; International Center for Colorectal and Urogenital Care, Children's Hospital Colorado, Aurora, CO
This was a complex case 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. Covered Cloacal Exstrophy
María Zornoza, MD, Centro Colorrectal para Nińos, Puebla, Mexico
This was a complex case of cloacal exstrophy in a 5-year-old female patient who had undergone multiple surgeries in the United States for urinary and colorectal issues. The team performed a comprehensive evaluation, including renal and pelvic imaging, which revealed significant anatomical abnormalities. They proposed a surgical plan involving bladder augmentation, continent urinary diversion, and preservation of the colostomy, which was successfully executed. Postoperatively, the patient experienced a brief episode of bilious vomiting due to a partial small bowel obstruction, but the issue was resolved with conservative management. The patient now has a functioning augmented bladder with a continent urinary diversion, maintains her colostomy, and wears normal underwear, though she does not have a vagina.
Case 3. Female Patient 8 Months Old with Late Diagnosis of Anorectal Malformation
Andrea Bischoff, M.D.; International Center for Colorectal and Urogenital Care, Children's Hospital Colorado, Aurora, CO
This female patient was born with a cardiac condition and had cardiac surgery. And she was suffering from severe constipation. So she went to the gastroenterologist. The gastroenterologist tried to do a digital exam, couldn't do it, and that's how the patient came to Dr. Bischoff. Dr. Alberto Peña shared a learning point about managing constipation in a young patient with a tiny anus, highlighting the importance of admitting the patient and performing a gentle cleanout.