AIM:To assess the effectiveness and safety of imagingguided percutaneous cecostomy in the management of pediatric patients with organic fecal incontinence.METHODS:Twenty three cecostomies were performed on 21 children with organic fecal incontinence(13 males,8 females),aged from 5 to 16 years(mean 9.5 years).Thirteen patients had neurogenic fecal incontinence and 8 patients had anorectal anomalies.Procedures were performed under general anesthesia and fluoroscopic guidance.Effectiveness and complication data were obtained for at least 1 year after the procedure.RESULTS:Cecostomy was successful in 20 patients(primary technical success rate 95).Cecostomy failed in one patient due to tube breakage(secondary technical success rate 100).The tubes were in situ for an average of 18 mo(range 12-23 mo).Eighteen patients(87) expressed satisfaction with the procedures.Resolution of soiling was achieved in all patients with neurogenic fecal incontinence(100) and in 5 of 8 patients with anorectal anomalies(62.5).Eleven patients(52) experienced minor problems.No major complications were noted.CONCLUSION:Percutaneous cecostomy improves the quality of life in children with organic fecal incontinence.A satisfactory outcome is more prevalent in patients with neurogenic fecal incontinence than anorectal anomalies.