Pediatric Colorectal Surgery

Colorectal surgical care can help treat a variety of intestinal and digestive conditions impacting a child’s wellbeing, including:

• Inflammatory bowel disease
• Familial Polyposis Syndromes
• Anorectal malformations/Imperforate anus, with or without a fistula
• Hirschsprung’s disease
• Chronic Constipation/Fecal Incontinence

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Conditions we treat:

Chronic Constipation/Fecal Incontinence: Learn more

Imperforate anus, with or without a fistula (Anorectal malformations): Anorectal malformations occur when the anus and rectum don’t develop properly during pregnancy. These malformations can result in a variety of problems, but each of them result in a child who struggles to pass bowel movements.

Inflammatory bowel disease: Inflammatory bowel disease (IBD) encompasses conditions, including ulcerative colitis and Crohn’s disease, that cause inflammation in the colon and/or small intestine. IBD in children is often more severe and difficult to treat than IBD that emerges in adults, requiring a multidisciplinary care approach to manage the condition. Surgical intervention may be recommended if you have medical treatment has failed and surgery can help increase a child’s quality of life.

Hirschsprung’s disease: Hirschsprung’s disease is a congenital condition that prevents an infant or child from passing stool. It is caused by missing nerve cells in the colon and/or large intestine. These enteric nerves trigger muscle contractions that move stool through the intestine, so without them, children can experience constipation or complete blockage of the intestine. Most cases of Hirschsprung’s disease are diagnosed within the first two months following birth, but milder cases may not be diagnosed until later in childhood.

Familial Polyposis: Familial adenomatous polyposis (FAP) is an inherited disorder that eventually leads to cancer of the large intestine and rectum. For most people with polyposis, they will begin to develop benign growths in their colon as early as their teenage years. Unless the colon is removed, these polyps will become cancerous. On average, people with untreated polyposis develop colon cancer around the age of 39. Some people have a variant of the disorder that delays polyp growth and the onset of colorectal cancer.

Procedures and Services We Offer:

Colostomy: In a colostomy, the large intestine is divided into two sections, and the ends of the intestine are brought through the abdominal wall and connected to collection bags outside the body that allow stool and mucus to pass without impairing digestion.

Imperforate anus, with or without a fistula (Anorectal malformations): These malformations can be corrected and, depending on the location of the deformity, may require more than one procedure.

For lower lesions, a surgeon will perform a kind of pull through procedure called a posterior sagittal anorectoplasty (PSARP). This procedure repositions the rectum and creates an anus within the sphincter muscle. During the procedure, the surgeon will lift the rectum up and away from its inappropriate location near the urinary tract or vagina and positions it within the anal sphincter muscles to create an opening. This procedure can be done with minimally invasive techniques.
If the malformation is a higher lesion, a baby may benefit from a diverting colostomy first, with a PSARP later on at about three to four months of age.

Intestinal Surgery for Crohn’s Disease: Because Crohn’s disease effects a larger area of the digestive tract than ulcerative colitis, surgical intervention is determined by each individual circumstance.

Pull-Through Procedure: When used to treat Hirschsprung’s Disease, a pull-through procedure removes the malformed sections of the intestine and reconnects the healthy intestine to the anus. This enables the child to pass stool normally once recovered. Our physicians can perform this procedure laparoscopically or using the transanal soave approach, which enables the pull through to be completed entirely through the anus, leaving no scars.

Restorative Proctocolectomy with Ileoanal J-Pouch: In select children where this procedure is appropriate, a restorative proctocolectomy with an ileoanal J-pouch can cure ulcerative colitis and significantly reduce the risk of intestinal cancer. This procedure, for those with UC and familial adenomatous polyposis, removes the diseased colon and rectal tissue while preserving as much normal elimination and continence as possible.