“Pull-Through” Surgery Gives Young Patient the Gift of Play


Shortly after Giovanni was born at a Southern California hospital, nurses noticed he had a rare abnormality. They fed him and his stomach swelled up and remained distended. Further examination revealed that Giovanni had an anorectal malformation that occurs in roughly 1 in 5,000 births. His colon did not develop in the right location, making it impossible for Giovanni to have a normal bowel movement.

Three years later, Giovanni has normal colorectal function thanks to the Pediatric Surgery team at Shriners Hospitals for Children — Northern California.

Giovanni, 3, enjoys playing freely with other kids. “The situation stopped him from doing a lot of things. He couldn’t go swimming or play for long, uninterrupted periods of time,” said his mother Joequeshia, who also feels liberated by the surgery. “I did not seek child care because people didn’t understand his situation and were uncomfortable dealing with the colostomy bag,” she said.

Young Shriners Patient playing

Joequeshia sought help for her young son near their family’s home in Southern California, but it was difficult to find programs that specialized in treating children with the rare disorder. Doctors at Loma Linda University Medical Center suggested they contact the Northern California Shriners Hospital where pediatric surgeons lead a Bowel Management Program for children with colorectal disorders.

Giovanni had his first appointment with Shriners Hospital pediatric surgeon Payam Saadai, M.D., in June of 2018.

“I felt like we were finally where we are supposed to be. The doctors and nurses gave me reassurance we didn’t get from other hospitals,” said Joequeshia.

Young patient riding a trike

In September Dr. Saadai performed surgery to repair the malformation in which the end of the large intestine (or rectum) is surgically “pulled through” to the bottom to allow an outlet for stooling. “The surgery allows the patient to stool more normally and frees them from a permanent colostomy bag,” says Dr. Saadai.

“We follow our patients long-term, well into teen-age years, to make sure that they have no issues with continence or soiling at different stages of their lives. It is very important to us to ensure our patients are able to engage in regular activities. We want them to be able to go on sleep-overs, field trips, swimming, and camping without worry,” he adds.

Just days after the surgery, Giovanni was riding a trike and playing with other children in the hospital’s central play area. Watching with a smile was his mom, who said, “This is by far the best hospital I’ve ever been to. This is really for kids and that’s a wonderful thing.”