Different varieties of colonic atresia in a series of 13 patients

Abstract

Purpose The aim of this study was to review our experience in the management and outcome of colonic atresia, either isolated or associated with anorectal anomalies. Methods A total of 13 neonates with colonic atresia were operated upon in the Pediatric Surgery Unit of Zagazig University Hospital between August 2004 and April 2010. Complete data including age, sex, clinical findings, diagnostic procedure, associated anomalies, preoperative management, intraoperative findings, operative procedures, postoperative course, and outcome were reported for each patient. Results Colonic atresia was found in 13 patients, including nine boys (69.2%) and four girls (30.8%). It was located in the ascending colon in four (30.8%) patients, in the transverse colon in three (23%), and in the sigmoid colon in four (30.8%). The other two (15.4%) patients had colonic atresias extending to the small bowel. Two patients had associated anorectal anomalies. Type III colonic atresia was observed in six patients (46.2%), type II in three (23%), and type I in four patients (30.8%). The treatment included resection and primary anastomosis in seven patients (53.8%) and diverting colostomy in six (46.2%). Two patients died: one because of severe neonatal sepsis and the other because of severe cardiac anomalies. One patient developed anastomotic leakage and another had anastomotic dysfunction. Conclusion Colonic atresia is an uncommon cause of neonatal intestinal obstruction. The combination of colonic atresia and anorectal anomalies should be taken into consideration. Proper postoperative care and management of postoperative complications improve the outcome. Keywords : anorectal anomalies, atresia, colon