Cases Presented
Video Summary of Cases Presented
The November 2025 International Colorectal Web Meeting featured a case of a mislocated anus in a Kenyan patient and discussing management options, followed by a literature review on re-operating patients for bowel control by Dr. Peña and Dr. Bischoff. The discussion then moved to a complex anorectal urogenital malformation case presented by Dr. Wulan Ayudasari from Indonesia, with recommendations for a step-by-step approach to improve the patient's quality of life. The conversation ended with presentations of various pediatric surgical cases by Dr. Bischoff, and Dr. Lorena Campos emphasizing the importance of meticulous technique and careful planning for future interventions.
Case 1. Mislocated Rectum Post-PSARP
Daniel Tamirat Cherkos, M.D.; IAGC Tenwek Hospital, Bomet, Kenya
This was a case of a 15-year-old Kenyan patient with a mislocated anus after posterior sagittal anorectoplasty (PSARP). The case described the challenges of managing post-PSARP mislocated anus and the potential benefits of redo PSARP versus stoma reversal and bowel management. The discussion highlighted the lack of universally accepted evidence-based recommendations for managing such cases and the need for further discussion on whether redo PSARP should be considered for patients with poor continence predictors. The presentation sparked a discussion on the indications for redo PSARP, the risks and benefits associated with the procedure, and the potential for improved continence outcomes.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 discussion highlighted the importance of thorough preoperative imaging and careful surgical planning in such rare anomalies.
Case 2. Five-Year-Old Female Patient with Complex Anorectal/Urogenital Malformation
Wulan Ayudyasari, M.D., Cipto Mangunkusumo Hospital, Univeritas Indonesia, Jakarta, Indonesia
This was a complex case of anorectal urogenital malformation. The patient, a 5-year-old girl, has a single orifice for defecation and urination, with a history of transverse colostomy due to difficulty in defecation. The moderators recommended performing a proximal lapogram to determine if the patient has a short colon or ileum, and suggested disconnecting the colon from the cavity to create a true end colostomy and emphasized the need for a step-by-step approach to improve the patient's quality of life, including bowel management through the stoma and urinary control through bladder reconstruction. The discussion highlighted the complexity of the malformation and the importance of careful planning for future interventions.
Case 3. Female Patient 3 Years Old with a Recto-Perineal Fistula
Lorena Campos, M.D.; Hospital Infantil de México Federico Gómez, Mexico City, Mexico
Case of a 3-year-old girl with a recto-perineal fistula and colonic duplication, which was successfully treated with a lateral anastomosis.
Case 4. Two Male Patients with Distal Colostograms
Andrea Bischoff, M.D.; International Center for Colorectal and Urogenital Care, Children's Hospital Colorado, Aurora, CO
Two cases of anorectal malformations, emphasizing the importance of performing surgery with the assumption of a fistula even when distal colostograms show none. Stressed are the need for meticulous technique and the use of an electrical stimulator to determine the correct location for the rectum.