The purpose of a study published in Pediatric Surgery International was to describe the experience in patients with chronic idiopathic constipation complicated by megarectosigmoid and fecal incontinence, who underwent a primary sigmoidectomy and appendicostomy. This study reviewed eight patients referred to the Colorectal Center from 2014 to 2016 with chronic idiopathic constipation and undergoing a sigmoidectomy and appendicostomy. Here, previous medical treatment, indications for the surgical procedure and outcomes were analyzed. The age-range of these patients at the time of operation was 5-19 years, while the duration of constipation was 4-15 years. The findings revealed that all patients received multiple laxatives, mainly polyethylene glycol, and all had a history of severe social problems. Four patients were detected with autism. The indications for surgery were an unsuccessful laxative trial, refusal to continue with rectal enemas or both, as well as social fear of continued fecal incontinence. It was also noted that all patients recovered to having daily bowel movements without fecal accidents post-operatively. Therefore, it was inferred that great benefits can be obtained from primary sigmoidectomy and appendicostomy in selected patients with chronic idiopathic constipation complicated by megarectosigmoid and fecal incontinence.