The Malone Stoma With Antegrade Colonic Enemas for Chronic Constipation in Adults

Abstract

The Malone stoma with antegrade colonic enemas (MACE) is a procedure predominantly described in the European literature for treatment of chronic constipation refractory to medical management. Chronic constipation may be secondary to colonic or rectal inertia, or a condition known as pelvic floor dysfunction. We describe a case of a 22-year-old female with chronic constipation secondary to severe rectal and colonic inertia. She had an unexpected congenital anatomic anomaly discovered intra-operatively which made a restorative proctocolectomy impossible. The MACE procedure was performed after an initial proctectomy with coloanal anastomosis, and the patient has now lived free of constipation for 6 years with an acceptable bowel regimen. J Med Cases. 2013;4(11):762-764 doi: https://doi.org/10.4021/jmc1524e