Congenital Descending Colonic Stenosis with Perforation of Transverse Colon in a Neonate: A Case Report

A Baba,A Rashid,Ah Shera,Na Bhat,R Hamid

doi:10.3126/jnps.v32i1.5446

Abstract

Colonic atresia and stenosis are rare causes of intestinal obstruction in the infant. Only 10 cases have been reported in Literature since 1966 and only one late-onset case has been reported in Literature until now. We describe the case of a 3 day old baby presenting with abdominal distension, failure to pass meconium and vomiting. X-ray of the abdomen showed dilated gut loops. Exploratory laparotomy was performed. At the junction of descending and sigmoid colon a stenosis was found, laparotomy also revealed a perforation of transverse colon. Transverse colostomy and a mucous fistula of sigmoid colon was performed after resecting stenosing segment and colon distal to perforation site upto stenosing site. Diagnosis was confirmed on histopathology. Colostomy was close after six weaks with uneventful recovery. Considering both the Literature and our case, congenital colonic stenosis should be considered one of the rare differential diagnoses in a neonate presenting as complete or partial intestinal obstruction. Key words: Colonic Stenosis; Perforation; Obstruction DOI: http://dx.doi.org/10.3126/jnps.v32i1.5446 J. Nepal Paediatr. Soc. Vol.32(1) 2012 73-75

Highlights

Colonic stenosis is a rare clinical entity
Ours is the first case of congenital colonic stenosis (CCS) involving descending colon and leading to perforation in the transverse colon in a three day old neonate
We presented a case of a neonate three days old having abdominal distention and inability to pass meconium and vomiting since birth

Summary

Introduction

Colonic stenosis is a rare clinical entity. Incidence reported is 1/40,000 births. Ours is the first case of congenital colonic stenosis (CCS) involving descending colon and leading to perforation in the transverse colon in a three day old neonate. We presented a case of a neonate three days old having abdominal distention and inability to pass meconium and vomiting since birth. Saline was injected into the colon which could not pass beyond the stenosed segment (Figure 2,3,4). This confirmed the complete obstruction of the colon. The perforation site was brought as end colostomy the colon distal to perforation and up to stenosed segment was resected and sigmoid colon brought as mucous fistula (Figure 5). Congenital Descending Colonic Stenosis with Perforation of Transverse Colon in a Neonate: A Case Report

Discussion

Conclusion

Louw JH

Philippart AI

12. Sax EJ