Last week, I asked what would you do with this ARM female patient who underwent initial repair (after a newborn colostomy) for what was likely a rectovestibular fistula. After the colostomy was closed she passed stool via the vagina. Below is a contrast study showing the fistula and the distal rectum.
This will be a very challenging redo as it looks like the neorectum is severely scarred and this was confirmed on exam. So the entire rectum needs to be mobilized up past the peritoneal reflection likely, and a healthy pull through of left colon will be needed. The vaginal fistula can be closed and patched with an ischiorectal fat pad.
For this week, we have discuss rectal prolapses following PSARP and here is one such example. How do you figure out whether to do a minor trim at the skin level or to do a full PSARP? And for this below which case which would you choose.
Please note the dates below:
Here is the current list of the Colorectal Quiz podcasts, best viewed via the StayCurrent app.
See the latest podcast at the bottom.
Colorectal Quiz Episode 1 ARM - Low Bulbar Fistula, https://staycurrentapp.app.link/wK2FhonUEhb
Colorectal Quiz Episode 2 When to redo a PSARP https://staycurrentapp.app.link/RX2eeDqUEhb
Colorectal Quiz Episode 3 Hirschprung Disease https://staycurrentapp.app.link/UnFRkprUEhb
Colorectal Quiz Episode 3.5 Proximal Hirschsprung Disease https://staycurrentapp.app.link/JiaWCGsUEhb
Colorectal Quiz Episode 4 Classic Hirschsprung disease - Surgical Technique https://staycurrentapp.app.link/qGWLoGtUEhb
Colorectal Quiz Episode 5 Proximal Hirschsprung Disease Surgical Technique https://staycurrentapp.app.link/AiGHjcvUEhb
Colorectal Quiz Episode 6 Bowel Management Part 1 https://staycurrentapp.app.link/SVuVYWvUEhb
Colorectal Quiz Episode 7 Bowel Management Part 2 https://staycurrentapp.app.link/b8IhkKwUEhb
Colorectal Quiz Episode 8 Motility Disorders Part 1 https://staycurrentapp.app.link/NRerIoxUEhb
Colorectal Quiz Episode 9 Motility Disorders Part 2 https://staycurrentapp.app.link/s2cVlbyUEhb
Colorectal Quiz Episode 10 Total Colonic Hirschsprung Disease Part 1 https://staycurrentapp.app.link/fEtTMRyUEhb
Colorectal Quiz Episode 11 Total Colonic Hirschsprung's Part 2 https://staycurrentapp.app.link/MNqS9yzUEhb
Colorectal Quiz episode 12 Newborn ARM Part 1 https://staycurrentapp.app.link/x5UL6DBUEhb
Colorectal Quiz Episode 13 Newborn ARM Part 2 https://staycurrentapp.app.link/YqVpTmCUEhb
Colorectal Quiz Episode 14 ARM Newborn Part 3 https://staycurrentapp.app.link/x9mUY7CUEhb
Colorectal Quiz Episode 15 Bowel Management in Spinal Pts. Need for a urologist Part 1 https://staycurrentapp.app.link/etX3mPDUEhb
Colorectal Quiz Episode 16 Bowel Management in Spinal Pts. Need for a urologist Part 2 https://staycurrentapp.app.link/5C7GsJIDEhb
Colorectal Quiz Episode 17 Cloaca Part I https://staycurrentapp.app.link/YGPmYZPEPhb
Colorectal Quiz Episode 18 Cloaca Part II https://staycurrentapp.app.link/vUEzQxG80hb
Colorectal Quiz Episode 19 Hirschsprung Disease - The Obstructed Patient Part 1 https://staycurrentapp.app.link/gBzrAtLKLib
Colorectal Quiz: Episode 20 Hirschsprung Disease – The Obstructed Patient Part 2 https://staycurrentapp.app.link/W7kEcqB6vjb
Colorectal Quiz Episode 21 The History of Hirschsprung Disease https://staycurrentapp.app.link/QXtFg2UlTjb
Colorectal Quiz Episode 22 Hirschsprung Disease - the Soiling Patient Part 1 https://staycurrentapp.app.link/OII38hVhQkb
Colorectal Quiz Episode 23 Hirschsprung Disease The Soiling Patient Part 2 https://staycurrentapp.app.link/DA4WEDIcXlb
Colorectal Quiz Episode 24 Cloaca Part 3 https://staycurrentapp.app.link/3uuEG49mkmb
Colorectal Quiz Episode 25 Perineal Groove https://staycurrentapp.app.link/PxlGWtfswmb
Colorectal Quiz Episode 26 Perianal Crohn's Disease https://staycurrentapp.app.link/qQbadIDjTmb
Colorectal Quiz Episode 27: Delayed Hirschsprung Disease
https://staycurrentapp.app.link/v37xYPDSDnb
Colorectal Quiz Episode 28: Female ARM Management - Perineal Fistula https://staycurrentapp.app.link/lLH7KQr20nb
Colorectal Quiz Episode 30: Tethered Cord https://staycurrentapp.app.link/sE57H6IPzob
Colorectal Quiz Episode 31: Müllerian Anomalies in patients with ARM
https://staycurrentapp.app.link/FuQyrjuC8ob
Colorectal Quiz Episode 32: Anorectal Malformations and Cardiac Anomalies https://staycurrentapp.app.link/3yJWt3t1rqb
Colorectal Quiz Episode 33: Cloacal exstrophy https://staycurrentapp.app.link/H4l85Pe2isb
Our weekly quiz is also posted on the Pediatric Colorectal and Pelvic Learning Consortium, (PCPLC) website, www.pcplc.org
https://www.pcplc.org/educational_courses/quizzes
Access code is: pcplc-2022!
The upcoming 13th European Colorectal Congress will be held in Croatia September 21-24, 2022. Marko Mesic is organizing. Abstract submission is open and the deadline is July 15th.
The PCPLC scientific and didactic course will be help in person! November 2-4, 2022, in Cincinnati, Ohio, USA.