Children with severe constipation and a neurodiverse disorder (Autism and/or developmental delay) represent a challenging bowel management group. Treatment outcomes with laxative or enema therapy remain limited and are often complicated by patient/caregiver compliance. We hypothesized that children with neurodiverse disorders and severe constipation would benefit from a bowel management program (BMP) that includes early use of antegrade enemas.

We read the article by Neogi et al. [1] with great interest about “Laparoscopic versus open appendicectomy for complicated appendicitis in children: A systematic review and meta-analysis.” (doi: 10.1016/j.jpedsurg.2021.07.005.). The research included four randomized controlled trials (266 LA versus 354 OA) and thirty-six case-controlled trials (2580 LA versus 3043 OA). After analyzing, they concluded that laparoscopy has a better overall complication profile compared to OA and should be the procedure of choice in children with complicated appendicitis.

Bowel management programs are efficacious in pediatric patients with fecal incontinence or intractable constipation unresponsive to standard treatment. No studies have been done examining outcomes in adults. The objective of this study was to assess continence and quality of life outcomes in adults who have underwent bowel management program.

Gallbladder disease (GBD) has become increasingly common in children. Established risk factors for GBD in childhood include hemolytic disease; ileal resections; obesity; cystic fibrosis; and the use of parenteral nutrition, ceftriaxone, and oral contraceptives. Notably, patients with cystic fibrosis (CF) face an increased risk of developing a wide range of CF-related conditions, including a significantly greater odds ratio for conditions such as cholelithiasis [1,2]. Furthermore, surgeons should be aware of the high possibility of encountering a difficult gallbladder operation in these patients.