A technique to reconstruct the anal sphincters following iatrogenic stretching related to a pull-through for Hirschsprung disease
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In brief
In brief
This article describes a surgical technique for reconstructing overstretched anal sphincters in patients experiencing fecal incontinence after Hirschsprung pull-through procedures. Two cases demonstrate sphincter tightening as an alternative to bowel management programs when anatomic defects cause true incontinence.
Written by the GCMD Library team from the article.
Abstract
Soiling and fecal incontinence are troubling complications which can occur after a pull-through for Hirschsprung disease. They can usually be improved with proper medical management, but in some cases are the result of an anatomic defect related to overstretching of the sphincters and/or damage of the anal canal. For such patients the treatment of this true fecal incontinence is limited to a structured bowel management program with ante- or retrograde enemas to achieve social continence. Herein we report two such patients with overstretched sphincters and loss of the dentate line after an initial pull-through and describe a sphincter tightening technique to improve bowel control.