Fulminant Necrosis of the Colon Associated With Antegrade Continence Enemas

jpedsurg.org

We would like to inform the Editor and readers of Journal of Paediatric Surgery of a disturbing and severe complication related to bowel management with antegrade continence enema (ACE). Colonic necrosis occurred in two male patients aged 15 (patient 1) and 11 (patient 2) years, both of whom had undergone repair of rectoprostatic fistula during infancy, and appendicostomy at age 5 years to manage faecal incontinence with ACE. Patient 1 had no associated congenital malformations, and had an excellent physical health.

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Article · Mar 2025 · 1 min read

In brief

Case report describing fulminant colonic necrosis as a severe complication of antegrade continence enema (ACE) therapy in two pediatric patients with repaired anorectal malformations. Both patients had undergone appendicostomy for fecal incontinence management following rectoprostatic fistula repair in infancy.

Fulminant colonic necrosis is a rare but severe complication of antegrade continence enema (ACE) therapy in pediatric patients.
Two adolescent males with repaired anorectal malformations developed this life-threatening complication years after appendicostomy.
Clinicians using ACE for fecal incontinence management must maintain high vigilance for acute abdominal symptoms suggesting bowel ischemia.
Early recognition and surgical intervention are critical when colonic necrosis occurs in ACE patients to prevent mortality.

Written by the GCMD Library team from the article.

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