Atresia of the Colon: Etiological Aberrations, Clinical Observations, and Challenges in Management

Authors

  • Nitin Pant K G M U, Chowk, Lucknow, India
  • Sudhir Singh Assistant Professor Paediatric Surgery Department
  • Jiledar Rawat Professor Department of Pediatric Surgery, King George Medical University, Lucknow, 226003 India.
  • Shiv Narayan Kureel Department of Pediatric Surgery, King Georges Medical University, Lucknow, 226003, India
  • Ashish Wakhlu Professor Department of Pediatric Surgery, King Georges Medical University, Lucknow, 226003, India

DOI:

https://doi.org/10.21699/jns.v7i2.743

Keywords:

Colonic atresia, Dehydration, Gastrografin enema, Intestinal stoma, Mesenteric vascular occlusion

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.

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Author Biographies

Nitin Pant, K G M U, Chowk, Lucknow, India

Assistant Professor

Paediatric Surgery Department

Sudhir Singh, Assistant Professor Paediatric Surgery Department

Assistant Professor

Paediatric Surgery Department

Jiledar Rawat, Professor Department of Pediatric Surgery, King George Medical University, Lucknow, 226003 India.

Professor

Department of Pediatric Surgery, King George Medical University, Lucknow, 226003 India.

Shiv Narayan Kureel, Department of Pediatric Surgery, King Georges Medical University, Lucknow, 226003, India

Department of Pediatric Surgery, King Georges Medical University, Lucknow, 226003, India

Ashish Wakhlu, Professor Department of Pediatric Surgery, King Georges Medical University, Lucknow, 226003, India

Professor

Department of Pediatric Surgery, King Georges Medical University, Lucknow, 226003, India

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Published

2018-04-08

How to Cite

1.
Pant N, Singh S, Rawat J, Kureel SN, Wakhlu A. Atresia of the Colon: Etiological Aberrations, Clinical Observations, and Challenges in Management. J Neonatal Surg [Internet]. 2018Apr.8 [cited 2021May11];7(2):22. Available from: https://jneonatalsurg.com/ojs/index.php/jns/article/view/385

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