Fulminant Necrosis of the Colon Associated With Antegrade Continence Enemas

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.