Amanda Jensen
51 statements · 11 topics · summaries given as host listed separately
Colorectal / ARM & Hirschsprung
· series host
Intestinal Rehab
· guest expert
Motility / Pseudo-obstruction
· guest expert
Featured statements
Female ARM exam requires determining number of perineal orifices: three orifices means perineal or vestibular fistula; two orifices raises question of fistula presence, vaginal atresia, or rectovaginal fistula; one orifice is cloaca
clinical ·
Colorectal / ARM & Hirschsprung
Congenital perineal groove is characterized by an exposed wet sulcus with non-keratinized mucous membrane extending from the posterior vaginal fourchette to the anterior ridge of the anal orifice; the anus can be normal.
clinical ·
Anorectal Malformation
VACTERL association requires three or more anomalies: vertebral, imperforate anus, cardiovascular, tracheoesophageal fistula, esophageal atresia, renal/radial, and limb defects.
clinical ·
Cloaca
The majority of congenital perineal grooves are observed over time and left alone; they will usually epithelialize by age 2 without surgical correction.
clinical ·
Anorectal Malformation
Nocturnal soiling with daytime control can occur if the dentate line is lost (from overstretching) with some preservation of the external sphincter.
clinical ·
Colorectal / ARM & Hirschsprung
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Amanda's statements about Anorectal Malformation 6 statements
Open the Anorectal Malformation collection →
Colorectal Quiz Episode 14: ARM Newborn Part 3
Colorectal Quiz 25: Perineal Groove
Statement
A quality normal anus requires three features: (1) location within the sphincter complex, (2) adequate size, and (3) presence of a perineal body.
Open
Statement
Congenital perineal groove is characterized by an exposed wet sulcus with non-keratinized mucous membrane extending from the posterior vaginal fourchette to the anterior ridge of the anal orifice; the anus can be normal.
Open
Statement
The majority of congenital perineal grooves are observed over time and left alone; they will usually epithelialize by age 2 without surgical correction.
Open
The Colorectal Quiz Episode 23: Hirschsprung Disease - The Soiling Patient...
Colorectal Quiz Episode 29: Female ARM-Post Op Management
Amanda's statements about Cloaca 4 statements
Colorectal Quiz Episode 18: Cloaca Part 2
Colorectal Quiz Episode 18: Cloaca Part 2
Colorectal Quiz Episode 17: Cloaca Part 1
Statement
VACTERL association requires three or more anomalies: vertebral, imperforate anus, cardiovascular, tracheoesophageal fistula, esophageal atresia, renal/radial, and limb defects.
Open
Quotation
This is, if I look at my textbooks behind me, this is not written in the chapters written by people on this podcast of what to do for cloacas and hydrocorpus. So this is huge.
Open
Amanda's statements about Colorectal / ARM & Hirschsprung 22 statements
Open the Colorectal / ARM & Hirschsprung collection →
Colorectal Quiz Episode 13: Newborn ARM Part 2
Statement
Three qualities to assess in anal location are: anal size, location (whether surrounded by sphincter), and perineal body size
Open
Statement
Urogenital sinus plus normal anus is an endocrine problem, but no anus and urogenital sinus is a cloaca
Open
Statement
Female ARM exam requires determining number of perineal orifices: three orifices means perineal or vestibular fistula; two orifices raises question of fistula presence, vaginal atresia, or rectovaginal fistula; one orifice is cloaca
Open
Colorectal Quiz Episode 14: ARM Newborn Part 3
Colorectal Quiz Episode 18: Cloaca Part 2
Colorectal Quiz Episode 19: Hirschsprung Disease - The Obstructed Patient Part 1
The Colorectal Quiz Episode 22: Hirschsprung Disease - the Soiling Patient Part 1
Quotation
Until next time, this is Amanda Jensen at Riley Children's. And remember, knowledge should be free.
Open
The Colorectal Quiz Episode 23: Hirschsprung Disease - The Soiling Patient Part 2 -The Dentate Line and Motility
Statement
Nocturnal soiling with daytime control can occur if the dentate line is lost (from overstretching) with some preservation of the external sphincter.
Open
Colorectal Quiz 25: Perineal Groove
Statement
A quality normal anus requires three features: (1) location within the sphincter complex, (2) adequate size, and (3) presence of a perineal body.
Open
Statement
Congenital perineal groove is characterized by an exposed wet sulcus with non-keratinized mucous membrane extending from the posterior vaginal fourchette to the anterior ridge of the anal orifice; the anus can be normal.
Open
Statement
The majority of congenital perineal grooves are observed over time and left alone; they will usually epithelialize by age 2 without surgical correction.
Open
The Colorectal Quiz Episode 23: Hirschsprung Disease - The Soiling Patient...
Colorectal Quiz Episode 28: Female ARM Management - Perineal Fistula
Statement
A normal anus must meet three criteria: appropriate size, centered in the sphincter, and presence of a perineal body.
Open
Colorectal Quiz Episode 29: Female ARM-Post Op Management
The Colorectal Quiz Episode 21: The History of Hirschsprung Disease
Quotation
Hey there listeners, it's Amanda Jensen from Riley Children's Hospital. I'm here today with Dr. Mark Levitt from Children's National and Dr. Jason Frischer from Cincinnati Children's. Today we are going to talk about Hirschsprung's disease and the history and where it all started.
Open
Quotation
And that wraps up episode 21, the history of Hirschsprung's disease for our colorectal quiz. This is Amanda Jensen from Riley Children's. Remember knowledge should be free.
Open
Colorectal Quiz Episode 18: Cloaca Part 2
Colorectal Quiz Episode 17: Cloaca Part 1
Statement
VACTERL association requires three or more anomalies: vertebral, imperforate anus, cardiovascular, tracheoesophageal fistula, esophageal atresia, renal/radial, and limb defects.
Open
Quotation
This is, if I look at my textbooks behind me, this is not written in the chapters written by people on this podcast of what to do for cloacas and hydrocorpus. So this is huge.
Open
Amanda's statements about Crohn's Disease 1 statement
Open the Crohn's Disease collection →
Colorectal Quiz Episode 19: Hirschsprung Disease - The Obstructed Patient Part 1
Amanda's statements about Enterocolitis 2 statements
Amanda's statements about Fecal Incontinence 2 statements
Open the Fecal Incontinence collection →
The Colorectal Quiz Episode 21: The History of Hirschsprung Disease
Quotation
Hey there listeners, it's Amanda Jensen from Riley Children's Hospital. I'm here today with Dr. Mark Levitt from Children's National and Dr. Jason Frischer from Cincinnati Children's. Today we are going to talk about Hirschsprung's disease and the history and where it all started.
Open
Quotation
And that wraps up episode 21, the history of Hirschsprung's disease for our colorectal quiz. This is Amanda Jensen from Riley Children's. Remember knowledge should be free.
Open
Amanda's statements about Hirschsprung disease 6 statements
Open the Hirschsprung disease collection →
The Colorectal Quiz Episode 22: Hirschsprung Disease - the Soiling Patient Part 1
Quotation
Until next time, this is Amanda Jensen at Riley Children's. And remember, knowledge should be free.
Open
The Colorectal Quiz Episode 23: Hirschsprung Disease - The Soiling Patient Part 2 -The Dentate Line and Motility
Statement
Nocturnal soiling with daytime control can occur if the dentate line is lost (from overstretching) with some preservation of the external sphincter.
Open
The Colorectal Quiz Episode 23: Hirschsprung Disease - The Soiling Patient...
The Colorectal Quiz Episode 21: The History of Hirschsprung Disease
Quotation
Hey there listeners, it's Amanda Jensen from Riley Children's Hospital. I'm here today with Dr. Mark Levitt from Children's National and Dr. Jason Frischer from Cincinnati Children's. Today we are going to talk about Hirschsprung's disease and the history and where it all started.
Open
Quotation
And that wraps up episode 21, the history of Hirschsprung's disease for our colorectal quiz. This is Amanda Jensen from Riley Children's. Remember knowledge should be free.
Open
Amanda's statements about Hirschsprung's-associated Enterocolitis 1 statement
Open the Hirschsprung's-associated Enterocolitis collection →
Colorectal Quiz Episode 19: Hirschsprung Disease - The Obstructed Patient Part 1
Amanda's statements about Hydrocolpos 4 statements
Open the Hydrocolpos collection →
Colorectal Quiz Episode 17: Cloaca Part 1
Statement
VACTERL association requires three or more anomalies: vertebral, imperforate anus, cardiovascular, tracheoesophageal fistula, esophageal atresia, renal/radial, and limb defects.
Open
Statement
VACTERL association requires three or more anomalies: vertebral, imperforate anus, cardiovascular, tracheoesophageal fistula, esophageal atresia, renal/radial, and limb defects.
Open
Quotation
This is, if I look at my textbooks behind me, this is not written in the chapters written by people on this podcast of what to do for cloacas and hydrocorpus. So this is huge.
Open
Quotation
This is, if I look at my textbooks behind me, this is not written in the chapters written by people on this podcast of what to do for cloacas and hydrocorpus. So this is huge.
Open
Amanda's statements about Perineal Fistula 1 statement
Open the Perineal Fistula collection →
Colorectal Quiz Episode 29: Female ARM-Post Op Management
Amanda's statements about Ulcerative Colitis 2 statements
Open the Ulcerative Colitis collection →
The Colorectal Quiz Episode 21: The History of Hirschsprung Disease
Quotation
Hey there listeners, it's Amanda Jensen from Riley Children's Hospital. I'm here today with Dr. Mark Levitt from Children's National and Dr. Jason Frischer from Cincinnati Children's. Today we are going to talk about Hirschsprung's disease and the history and where it all started.
Open
Quotation
And that wraps up episode 21, the history of Hirschsprung's disease for our colorectal quiz. This is Amanda Jensen from Riley Children's. Remember knowledge should be free.
Open
Summaries Amanda gave as host · 109 summaries
Recaps of other experts' statements, not Amanda's own clinical position.
Summaries Amanda gave as host · Anorectal Malformation 12 summaries
Open the Anorectal Malformation collection →
Colorectal Quiz Episode 13: Newborn ARM Part 2
Host summary
Amanda Jensen summarizing the discussion: Perineal groove can be misdiagnosed as contact dermatitis, trauma, or sexual abuse
Open
Host summary
Amanda Jensen summarizing the discussion: Congenital perineal groove usually epithelializes on its own by age two
Open
Host summary
Amanda Jensen summarizing the discussion: Three qualities to assess in anal location are: anal size, location (whether surrounded by sphincter), and perineal body size
Open
Host summary
Amanda Jensen summarizing the discussion: Urogenital sinus plus normal anus is an endocrine problem, but no anus and urogenital sinus is a cloaca
Open
Host summary
Amanda Jensen summarizing the discussion: Female ARM exam requires determining number of perineal orifices: three orifices means perineal or vestibular fistula; two orifices raises question of fistula presence, vaginal atresia, or rectovaginal fistula; one orifice is cloaca
Open
Colorectal Quiz Episode 14: ARM Newborn Part 3
Host summary
Amanda Jensen summarizing the discussion: VACTERL represents: V for vertebral, A for anorectal, C for cardiac, T and E for tracheoesophageal fistula, R for renal, and L for limb.
Open
Host summary
Amanda Jensen summarizing the discussion: V is for vertebral, A for anorectal, C for cardiac, T and E for trachoesophageal fistula, R for renal, and L for limb.
Open
The Colorectal Quiz Episode 23: Hirschsprung Disease - The Soiling Patient Part 2 -The Dentate Line and Motility
Host summary
Amanda Jensen summarizing the discussion: Nocturnal soiling with daytime control can occur if the dentate line is lost (from overstretching) with some preservation of the external sphincter.
Open
Colorectal Quiz 25: Perineal Groove
Host summary
Amanda Jensen summarizes what Dr. Jonathan Sutcliffe said: A quality normal anus requires three features: (1) location within the sphincter complex, (2) adequate size, and (3) presence of a perineal body.
Open
Host summary
Amanda Jensen summarizes what Dr. Jonathan Sutcliffe said: Congenital perineal groove is characterized by an exposed wet sulcus with non-keratinized mucous membrane extending from the posterior vaginal fourchette to the anterior ridge of the anal orifice; the anus can be normal.
Open
Host summary
Amanda Jensen summarizes what Dr. Jonathan Sutcliffe said: The majority of congenital perineal grooves are observed over time and left alone; they will usually epithelialize by age 2 without surgical correction.
Open
Colorectal Quiz Episode 28: Female ARM Management - Perineal Fistula
Host summary
Amanda Jensen summarizing the discussion: A normal anus must meet three criteria: appropriate size, centered in the sphincter, and presence of a perineal body.
Open
Summaries Amanda gave as host · Cloaca 14 summaries
Colorectal Quiz Episode 17: Cloaca Part 1
Host summary
Amanda Jensen summarizing the discussion: Cloaca or anorectal malformation is associated with VACTERL and requires workup as such.
Open
Host summary
Amanda Jensen summarizing the discussion: VACTERL association comprises: Vertebral anomalies, imperforate Anus, Cardiovascular anomalies, Tracheoesophageal fistula, Esophageal atresia, Renal/radial anomalies, and Limb defects. Three or more anomalies define the association.
Open
Host summary
Amanda Jensen summarizing the discussion: Initial workup should include NG tube and chest X-ray, cardiac echo, and pelvic and renal ultrasound to assess for TEF, cardiac anomalies, hydrocolpos, and hydronephrosis.
Open
Host summary
Amanda Jensen summarizing the discussion: Bilateral hydronephrosis with hydrocolpos requires management of the hydrocolpos as part of initial treatment.
Open
Host summary
Amanda Jensen summarizing the discussion: Single perineal orifice with no anal opening is a cloaca and does not need an endocrine workup. Whereas a perineal opening with a normal anus is a UG sinus and does need an endocrine workup.
Open
Colorectal Quiz Episode 18: Cloaca Part 2
Host summary
Amanda Jensen summarizing the discussion: The study 'Measure twice and cut once: comparing endoscopy and 3D cloacogram for common channel and urethral measurements in patients with cloacal malformations' was published in the Journal of Pediatric Surgery, October 2019.
Open
Colorectal Quiz Episode 18: Cloaca Part 2
Host summary
Amanda Jensen summarizing the discussion: The common channel takes a very significant turn as it gets behind the pubis, which is visible on lateral view imaging
Open
Host summary
Amanda Jensen summarizing the discussion: What we found when we studied it was that the cystoscopy significantly undermeasures the structures when you scope and you compare the same patient's 3D reconstruction to their scope.
Open
Host summary
Amanda Jensen summarizing the discussion: Cystoscopy significantly undermeasures anatomical structures compared to 3D reconstruction because the straight scope cannot measure the turn behind the pubis
Open
Host summary
Amanda Jensen summarizing the discussion: A study comparing endoscopy to 3D cloacogram showed that cystoscopy significantly under-reads the length of the common channel
Open
Host summary
Amanda Jensen summarizing the discussion: If urethral length is less than 1.5 cm, urogenital separation is advocated because performing TUM would result in the bladder neck sewn near the perineum, potentially rendering the patient incontinent
Open
Host summary
Amanda Jensen summarizing the discussion: If you were to do a TUM on a patient with a one centimeter urethra, and although these patients aren't common, they do exist, then you will have their bladder neck sewn right near the perineum. And that could render the patient incontinent.
Open
Host summary
Amanda Jensen summarizing the discussion: The majority of 1-3 cm common channel cloacas have normal length urethra and are amenable to TUM and PSARP
Open
Host summary
Amanda Jensen summarizing the discussion: If the vagina or vaginas cannot reach the perineum after urogenital separation, the patient may need vaginal replacement to bridge the gap
Open
Summaries Amanda gave as host · Colorectal / ARM & Hirschsprung 45 summaries
Open the Colorectal / ARM & Hirschsprung collection →
The Colorectal Quiz Episode 9: Motility Disorders Part 2
Host summary
Amanda Jensen summarizing the discussion: The case patient is a 10-year-old male with chronic constipation, soiling, poor appetite, and a water-soluble contrast enema showing a tortuous, redundant, dilated colon full of stool.
Open
Host summary
Amanda Jensen summarizing the discussion: Sitz marker study is not a replacement for colonic manometry.
Open
The Colorectal Quiz Episode 10: Total Colonic Hirschsprung Disease Part 1
Host summary
Amanda Jensen summarizing the discussion: It sounds like, yeah, duh, but I mean, think about it, this kid has Hirschprung's, so when they got that initial contrast rectal enema, it looks like a meconium plug, but really at that point, was a segment of Hirschprung's.
Open
Host summary
Amanda Jensen summarizing the discussion: After meconium passage, obtaining another contrast image will show the characteristic appearance of Hirschsprung disease
Open
Host summary
Amanda Jensen summarizing the discussion: Rare causes of failure to pass meconium include small left colon syndrome, hypothyroidism, opiates in the newborn system, magnesium sulfate from maternal preterm labor treatment, milk protein allergy, and microcolon intestinal hypoperistalsis syndrome
Open
Host summary
Amanda Jensen summarizing the discussion: Rectal biopsies should be attempted preoperatively before proceeding to the operating room
Open
Host summary
Amanda Jensen summarizing the discussion: If the patient is not doing well with irrigations, a procedure such as ileostomy or leveling colostomy is necessary to relieve pressure
Open
Host summary
Amanda Jensen summarizing the discussion: Loop ostomies should be avoided in Hirschsprung disease because stool will likely spill into the non-functional part of the colon
Open
Host summary
Amanda Jensen summarizing the discussion: A transition zone can often be visualized during surgery (open or laparoscopic), but when it cannot be seen, biopsies should be obtained at multiple levels
Open
Host summary
Amanda Jensen summarizing the discussion: It is acceptable to not perform a definitive procedure if only frozen section is available and there is uncertainty about the frozen section diagnosis
Open
Host summary
Amanda Jensen summarizing the discussion: Surgeons can wait for final pathology and return another day to perform the pull-through procedure if needed
Open
The Colorectal Quiz Episode 11: Total Colonic Hirschsprung's Part 2
Host summary
Amanda Jensen summarizing the discussion: For patients with high ileostomy output and failure to thrive, if urine sodium is less than 20 mmol/L, oral sodium supplementation is needed (GI absorption is better than IV).
Open
Host summary
Amanda Jensen summarizing the discussion: Both ileoanal and ileoDuhamel are acceptable options for pull-through in total colonic Hirschsprung disease.
Open
Host summary
Amanda Jensen summarizing the discussion: A post-op skincare protocol should be in place after pull-through; the Villanova et al. article is a reference.
Open
Host summary
Amanda Jensen summarizing the discussion: Enterocolitis is more common in total colonic Hirschsprung patients; currently there is no good option for preventing it, only directed treatment.
Open
Host summary
Amanda Jensen summarizing the discussion: Parents should be extremely proficient with irrigations and have a very low threshold to start them if there is concern for enterocolitis post-op.
Open
Colorectal Quiz Episode 13: Newborn ARM Part 2
Host summary
Amanda Jensen summarizing the discussion: Perineal groove can be misdiagnosed as contact dermatitis, trauma, or sexual abuse
Open
Host summary
Amanda Jensen summarizing the discussion: Congenital perineal groove usually epithelializes on its own by age two
Open
Host summary
Amanda Jensen summarizing the discussion: Three qualities to assess in anal location are: anal size, location (whether surrounded by sphincter), and perineal body size
Open
Host summary
Amanda Jensen summarizing the discussion: Urogenital sinus plus normal anus is an endocrine problem, but no anus and urogenital sinus is a cloaca
Open
Host summary
Amanda Jensen summarizing the discussion: Female ARM exam requires determining number of perineal orifices: three orifices means perineal or vestibular fistula; two orifices raises question of fistula presence, vaginal atresia, or rectovaginal fistula; one orifice is cloaca
Open
Colorectal Quiz Episode 14: ARM Newborn Part 3
Host summary
Amanda Jensen summarizing the discussion: VACTERL represents: V for vertebral, A for anorectal, C for cardiac, T and E for tracheoesophageal fistula, R for renal, and L for limb.
Open
Host summary
Amanda Jensen summarizing the discussion: V is for vertebral, A for anorectal, C for cardiac, T and E for trachoesophageal fistula, R for renal, and L for limb.
Open
Colorectal Quiz Episode 16: Bowel Management in Spinal Patients - Need for a Urologist Part 2
Host summary
Amanda Jensen summarizing the discussion: In spinal patients with poor pelvic floor muscles, using additional water in the balloon, larger balloon size, or different shapes like a cone helps with enema administration
Open
Colorectal Quiz Episode 17: Cloaca Part 1
Host summary
Amanda Jensen summarizing the discussion: Cloaca or anorectal malformation is associated with VACTERL and requires workup as such.
Open
Host summary
Amanda Jensen summarizing the discussion: VACTERL association comprises: Vertebral anomalies, imperforate Anus, Cardiovascular anomalies, Tracheoesophageal fistula, Esophageal atresia, Renal/radial anomalies, and Limb defects. Three or more anomalies define the association.
Open
Host summary
Amanda Jensen summarizing the discussion: Initial workup should include NG tube and chest X-ray, cardiac echo, and pelvic and renal ultrasound to assess for TEF, cardiac anomalies, hydrocolpos, and hydronephrosis.
Open
Host summary
Amanda Jensen summarizing the discussion: Bilateral hydronephrosis with hydrocolpos requires management of the hydrocolpos as part of initial treatment.
Open
Host summary
Amanda Jensen summarizing the discussion: Single perineal orifice with no anal opening is a cloaca and does not need an endocrine workup. Whereas a perineal opening with a normal anus is a UG sinus and does need an endocrine workup.
Open
Colorectal Quiz Episode 18: Cloaca Part 2
Host summary
Amanda Jensen summarizing the discussion: The study 'Measure twice and cut once: comparing endoscopy and 3D cloacogram for common channel and urethral measurements in patients with cloacal malformations' was published in the Journal of Pediatric Surgery, October 2019.
Open
The Colorectal Quiz Episode 22: Hirschsprung Disease - the Soiling Patient Part 1
Host summary
Amanda Jensen summarizes what Dr. Jason Frischer said: That was Doctor Jason Fisher from Cincinnati Children's.
Open
Host summary
Amanda Jensen summarizes what Dr. Marc Levitt said: That was Doctor Mark Levitt from Children's National.
Open
Host summary
Amanda Jensen summarizes what Dr. Hira Ahmad said: That was Doctor Hira Ahmad from Seattle Children's.
Open
The Colorectal Quiz Episode 23: Hirschsprung Disease - The Soiling Patient Part 2 -The Dentate Line and Motility
Host summary
Amanda Jensen summarizing the discussion: Nocturnal soiling with daytime control can occur if the dentate line is lost (from overstretching) with some preservation of the external sphincter.
Open
Colorectal Quiz 25: Perineal Groove
Host summary
Amanda Jensen summarizes what Dr. Jonathan Sutcliffe said: A quality normal anus requires three features: (1) location within the sphincter complex, (2) adequate size, and (3) presence of a perineal body.
Open
Host summary
Amanda Jensen summarizes what Dr. Jonathan Sutcliffe said: Congenital perineal groove is characterized by an exposed wet sulcus with non-keratinized mucous membrane extending from the posterior vaginal fourchette to the anterior ridge of the anal orifice; the anus can be normal.
Open
Host summary
Amanda Jensen summarizes what Dr. Jonathan Sutcliffe said: The majority of congenital perineal grooves are observed over time and left alone; they will usually epithelialize by age 2 without surgical correction.
Open
Colorectal Quiz Episode 18: Cloaca Part 2
Host summary
Amanda Jensen summarizing the discussion: The common channel takes a very significant turn as it gets behind the pubis, which is visible on lateral view imaging
Open
Host summary
Amanda Jensen summarizing the discussion: What we found when we studied it was that the cystoscopy significantly undermeasures the structures when you scope and you compare the same patient's 3D reconstruction to their scope.
Open
Host summary
Amanda Jensen summarizing the discussion: Cystoscopy significantly undermeasures anatomical structures compared to 3D reconstruction because the straight scope cannot measure the turn behind the pubis
Open
Host summary
Amanda Jensen summarizing the discussion: A study comparing endoscopy to 3D cloacogram showed that cystoscopy significantly under-reads the length of the common channel
Open
Host summary
Amanda Jensen summarizing the discussion: If urethral length is less than 1.5 cm, urogenital separation is advocated because performing TUM would result in the bladder neck sewn near the perineum, potentially rendering the patient incontinent
Open
Host summary
Amanda Jensen summarizing the discussion: If you were to do a TUM on a patient with a one centimeter urethra, and although these patients aren't common, they do exist, then you will have their bladder neck sewn right near the perineum. And that could render the patient incontinent.
Open
Host summary
Amanda Jensen summarizing the discussion: The majority of 1-3 cm common channel cloacas have normal length urethra and are amenable to TUM and PSARP
Open
Host summary
Amanda Jensen summarizing the discussion: If the vagina or vaginas cannot reach the perineum after urogenital separation, the patient may need vaginal replacement to bridge the gap
Open
Summaries Amanda gave as host · Constipation 1 summary
Open the Constipation collection →
Colorectal Quiz Episode 16: Bowel Management in Spinal Patients - Need for a Urologist Part 2
Host summary
Amanda Jensen summarizing the discussion: In spinal patients with poor pelvic floor muscles, using additional water in the balloon, larger balloon size, or different shapes like a cone helps with enema administration
Open
Summaries Amanda gave as host · Enterocolitis 3 summaries
Open the Enterocolitis collection →
The Colorectal Quiz Episode 22: Hirschsprung Disease - the Soiling Patient Part 1
Host summary
Amanda Jensen summarizes what Dr. Jason Frischer said: That was Doctor Jason Fisher from Cincinnati Children's.
Open
Host summary
Amanda Jensen summarizes what Dr. Marc Levitt said: That was Doctor Mark Levitt from Children's National.
Open
Host summary
Amanda Jensen summarizes what Dr. Hira Ahmad said: That was Doctor Hira Ahmad from Seattle Children's.
Open
Summaries Amanda gave as host · Hirschsprung disease 14 summaries
Open the Hirschsprung disease collection →
The Colorectal Quiz Episode 9: Motility Disorders Part 2
Host summary
Amanda Jensen summarizing the discussion: The case patient is a 10-year-old male with chronic constipation, soiling, poor appetite, and a water-soluble contrast enema showing a tortuous, redundant, dilated colon full of stool.
Open
Host summary
Amanda Jensen summarizing the discussion: Sitz marker study is not a replacement for colonic manometry.
Open
The Colorectal Quiz Episode 10: Total Colonic Hirschsprung Disease Part 1
Host summary
Amanda Jensen summarizing the discussion: It sounds like, yeah, duh, but I mean, think about it, this kid has Hirschprung's, so when they got that initial contrast rectal enema, it looks like a meconium plug, but really at that point, was a segment of Hirschprung's.
Open
Host summary
Amanda Jensen summarizing the discussion: After meconium passage, obtaining another contrast image will show the characteristic appearance of Hirschsprung disease
Open
Host summary
Amanda Jensen summarizing the discussion: Rare causes of failure to pass meconium include small left colon syndrome, hypothyroidism, opiates in the newborn system, magnesium sulfate from maternal preterm labor treatment, milk protein allergy, and microcolon intestinal hypoperistalsis syndrome
Open
Host summary
Amanda Jensen summarizing the discussion: Rectal biopsies should be attempted preoperatively before proceeding to the operating room
Open
Host summary
Amanda Jensen summarizing the discussion: If the patient is not doing well with irrigations, a procedure such as ileostomy or leveling colostomy is necessary to relieve pressure
Open
Host summary
Amanda Jensen summarizing the discussion: Loop ostomies should be avoided in Hirschsprung disease because stool will likely spill into the non-functional part of the colon
Open
Host summary
Amanda Jensen summarizing the discussion: A transition zone can often be visualized during surgery (open or laparoscopic), but when it cannot be seen, biopsies should be obtained at multiple levels
Open
Host summary
Amanda Jensen summarizing the discussion: It is acceptable to not perform a definitive procedure if only frozen section is available and there is uncertainty about the frozen section diagnosis
Open
Host summary
Amanda Jensen summarizing the discussion: Surgeons can wait for final pathology and return another day to perform the pull-through procedure if needed
Open
The Colorectal Quiz Episode 22: Hirschsprung Disease - the Soiling Patient Part 1
Host summary
Amanda Jensen summarizes what Dr. Jason Frischer said: That was Doctor Jason Fisher from Cincinnati Children's.
Open
Host summary
Amanda Jensen summarizes what Dr. Marc Levitt said: That was Doctor Mark Levitt from Children's National.
Open
Host summary
Amanda Jensen summarizes what Dr. Hira Ahmad said: That was Doctor Hira Ahmad from Seattle Children's.
Open
Summaries Amanda gave as host · Intestinal Rehab 2 summaries
Open the Intestinal Rehab collection →
The Colorectal Quiz Episode 9: Motility Disorders Part 2
Host summary
Amanda Jensen summarizing the discussion: The case patient is a 10-year-old male with chronic constipation, soiling, poor appetite, and a water-soluble contrast enema showing a tortuous, redundant, dilated colon full of stool.
Open
Host summary
Amanda Jensen summarizing the discussion: Sitz marker study is not a replacement for colonic manometry.
Open
Summaries Amanda gave as host · Motility / Pseudo-obstruction 2 summaries
Open the Motility / Pseudo-obstruction collection →
The Colorectal Quiz Episode 9: Motility Disorders Part 2
Host summary
Amanda Jensen summarizing the discussion: The case patient is a 10-year-old male with chronic constipation, soiling, poor appetite, and a water-soluble contrast enema showing a tortuous, redundant, dilated colon full of stool.
Open
Host summary
Amanda Jensen summarizing the discussion: Sitz marker study is not a replacement for colonic manometry.
Open
Summaries Amanda gave as host · Perineal Fistula 6 summaries
Open the Perineal Fistula collection →
Colorectal Quiz Episode 13: Newborn ARM Part 2
Host summary
Amanda Jensen summarizing the discussion: Congenital perineal groove usually epithelializes on its own by age two
Open
Host summary
Amanda Jensen summarizing the discussion: Perineal groove can be misdiagnosed as contact dermatitis, trauma, or sexual abuse
Open
Host summary
Amanda Jensen summarizing the discussion: Three qualities to assess in anal location are: anal size, location (whether surrounded by sphincter), and perineal body size
Open
Host summary
Amanda Jensen summarizing the discussion: Urogenital sinus plus normal anus is an endocrine problem, but no anus and urogenital sinus is a cloaca
Open
Host summary
Amanda Jensen summarizing the discussion: Female ARM exam requires determining number of perineal orifices: three orifices means perineal or vestibular fistula; two orifices raises question of fistula presence, vaginal atresia, or rectovaginal fistula; one orifice is cloaca
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Colorectal Quiz Episode 28: Female ARM Management - Perineal Fistula
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Amanda Jensen summarizing the discussion: A normal anus must meet three criteria: appropriate size, centered in the sphincter, and presence of a perineal body.
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Summaries Amanda gave as host · Spina Bifida 1 summary
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Colorectal Quiz Episode 16: Bowel Management in Spinal Patients - Need for a Urologist Part 2
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Amanda Jensen summarizing the discussion: In spinal patients with poor pelvic floor muscles, using additional water in the balloon, larger balloon size, or different shapes like a cone helps with enema administration
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Summaries Amanda gave as host · Total Colonic Aganglionosis 9 summaries
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The Colorectal Quiz Episode 10: Total Colonic Hirschsprung Disease Part 1
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Amanda Jensen summarizing the discussion: It sounds like, yeah, duh, but I mean, think about it, this kid has Hirschprung's, so when they got that initial contrast rectal enema, it looks like a meconium plug, but really at that point, was a segment of Hirschprung's.
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Amanda Jensen summarizing the discussion: After meconium passage, obtaining another contrast image will show the characteristic appearance of Hirschsprung disease
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Amanda Jensen summarizing the discussion: Rare causes of failure to pass meconium include small left colon syndrome, hypothyroidism, opiates in the newborn system, magnesium sulfate from maternal preterm labor treatment, milk protein allergy, and microcolon intestinal hypoperistalsis syndrome
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Amanda Jensen summarizing the discussion: Rectal biopsies should be attempted preoperatively before proceeding to the operating room
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Amanda Jensen summarizing the discussion: If the patient is not doing well with irrigations, a procedure such as ileostomy or leveling colostomy is necessary to relieve pressure
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Amanda Jensen summarizing the discussion: Loop ostomies should be avoided in Hirschsprung disease because stool will likely spill into the non-functional part of the colon
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Amanda Jensen summarizing the discussion: A transition zone can often be visualized during surgery (open or laparoscopic), but when it cannot be seen, biopsies should be obtained at multiple levels
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Amanda Jensen summarizing the discussion: It is acceptable to not perform a definitive procedure if only frozen section is available and there is uncertainty about the frozen section diagnosis
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Amanda Jensen summarizing the discussion: Surgeons can wait for final pathology and return another day to perform the pull-through procedure if needed
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