J Korean Assoc Pediatr Surg.  2012 Dec;18(2):68-74. 10.13029/jkaps.2012.18.2.68.

Clinical Experience with Colonic Atresia

Affiliations
  • 1Division of Pediatric Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. sckim@amc.seoul.kr
  • 2Division of Pediatric Surgery, GangNeung Asan Hospital, GangNeung, Korea.

Abstract

Colonic atresia (CA) is the rare cause of intestinal obstruction, and diagnosis of CA is difficult. But only few research has been performed, so little information has been available. The purposes of this study was to analyze the clinical findings of CA so that help physicians make decision properly. Children with CA who were treated at the division of pediatric surgery at Asan Medical Center in the period from January 1989 to December 2011 were evaluated retrospectively. A total of 6 children were treated with CA. These accounted for 2.7% of all gastrointestinal atresias managed in Asan Medical Center. Only one child was premature and low birth weight, the others were fullterm neonates and showed normal birth weight. Vomiting and abdominal distension were common symptoms and simple X-ray and barium study were used for diagnose of CA. But only 66.7% of the babies were diagnosed as CA pre-operatively. And 2 children out of 6 underwent re-operation due to missed CA at the time of the first operation. In aspect of types of atresia, the type IIIa were two, type IV were two, type I was one case, and one child showed rectal stenosis due to rectal web. Various operations were done according to individual findings and associated diseases. The 50% (n=3) of children underwent the primary anastomosis and the others (n=3) underwent colostomy first and staged operation later for missed CA or associated disease. All of them were recovered any significant complications. Therefore, the prognosis of CA is satisfactory if diagnosis and surgical management could be made properly. But because of the low incidence of CA, delay of diagnosis and treatment may occur. To prevent delay of diagnosis, we suggest prompt evaluation of doubtful infant and careful inspection of distal patency of bowel including whole colon and rectum when operating patients with intestinal atresia at any level.

Keyword

Colon; Atresia; Diagnosis

MeSH Terms

Barium
Birth Weight
Child
Colon
Colostomy
Constriction, Pathologic
Humans
Incidence
Infant
Infant, Low Birth Weight
Infant, Newborn
Intestinal Atresia
Intestinal Obstruction
Prognosis
Rectum
Retrospective Studies
Vomiting
Barium
Colon
Intestinal Atresia
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