Abstract

Objective: The objective of this study is to review the clinicoradiological profile, scheme of management and the outcome in cases of colonic atresia (CA), and ascertain an optimal approach for the treatment of CA to minimize morbidity and mortality. Design and Setting: This was a retrospective observational study carried out at a tertiary health‑care center. Duration: Total of 6 years duration (January 2011–December 2016).Materials and Methods: A retrospective analysis of 10 patients of CA managed over a 6- year period. Data related to demographics, clinical presentation, associated anomalies, radiologic, intraoperative findings, postoperative stay, complications, and outcome were analyzed.Results: There were three cases of Type II atresia involving terminal ileum, cecum, and adjacent colon. Three cases had proximal ascending colon atresia (Type IIIa [n = 2]; Type I [n = 1]) Type I [n=1], and two cases of type IIIa atresia of the hepatic flexure. Two babies had atresia involving the sigmoid colon; one had Type II atresia, while we were unable to assign a type to the other within the prevailing classification. Seven babies were initially treated with a stoma either in the ileum (n = 3), hepatic flexure (n = 2), and sigmoid colon (n = 2), whereas three were treated with a primary anastomoses. Cases treated with a primary anastomoses had lesser morbidity and a better outcome than those with an ileal or ascending colon stoma.Conclusion: Contrary to the theory of an acute antenatal vascular accident, CA may rarely result from a gradual, sequential obliteration of mesenteric vasculature. Primary anastomosis should be contemplated in proximal CA wherever possible as stomal complications, especially high stoma output can result in considerable morbidity.

Highlights

  • Colonic atresia (CA) is a less common site for intesti‐ nal atresia

  • We report 10 cases of CA managed over a 6-year period and describe the presentation, diag‐ nosis, management, and outcome of these patients

  • When the atretic part included the terminal ileum, cecum, and adjacent ascending colon, we used the term ileocolic atresia to differentiate them from cases where the atresia involved part of the ascending colon with a small proximal ascending colon stump, which were termed as atresia of proximal ascending colon

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Summary

INTRODUCTION

Colonic atresia (CA) is a less common site for intesti‐ nal atresia. We report 10 cases of CA managed over a 6-year period and describe the presentation, diag‐ nosis, management, and outcome of these patients. An attempt has been made to speculate on the likely embryogenesis of an unusual variant of CA. We aim to put forward the management options for patients with CA with a view to suggest a protocol to minimize morbidity and mortality

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