Zastosowanie zmodyfikowanej procedury MACE w rozwiÄ zaniu problemu nietrzymania stolca u 14-letniego chłopca

Faecal incontinence is a complex socio-medical problem. Although its pathophysiology has been well recognized, there are still no effective therapeutic methods. During the last years there have appeared reports on the operations improving continence and control over the defecation according to MACE procedure (Malone Antegrade Continence Enema). Patients with faecal incontinence after appendectomy are qualified for the application of modified MACE procedures. The case of 14-year-old boy operated because of imperforate anus and then reoperated because of anal stenosis is presented. Appendectomy was performed during the reoperation. The anal function was not obtained during the treatment. The boy was qualified for an operation with the modified MACE procedure because of total faecal incontinence. A neoappendix was created from a laterally based cecal flap. The final result of operative procedure was improved continence and control over the defecation.