Skip to main content

Advertisement

SpringerLink
Log in

Management options of congenital pouch colon—a rare variant of anorectal malformation

  • Original Article
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract

Purpose

Congenital pouch colon (CPC) was analysed for anatomical variations and surgical options.

Methods

Records of CPC patients managed between 1999 and 2014 were studied. CPC was classified as complete (CCPC) and incomplete (ICPC) pouch.

Results

Of 400 cases of high anorectal malformations, 68 cases were CPC (17 %). Male:female ratio was 2:1. Fistulous communication was colovesical, colocloacal, colovaginal and absent in 42, 15, 8 and 3 cases. ICPC and CCPC was 48 (70 %) and 20 (30 %). In neonatal period, proximal/end colostomy (31), ileostomy (6), pouch excision with abdominoperineal pull-through (18 cases) and coloplasty with end colostomy (7) were done. 6 presented as infants including 3 referred cases of CCPC with a window colostomy. Definitive surgery was completed in 56. Severe colonic dilatation after coloplasty was noted in 5, requiring excision of coloplasty segment in 2. Histopathology of excised pouch (45) showed muscle layer disorganization, widened sub mucosa, prominent vasculature and mature and immature ganglion cells, with no hypertrophy of nerve fibres. Diarrhoea and faecal incontinence (soiling) were more frequent in patients with CCPC versus ICPC. Six neonates with CCPC died. Six are awaiting definitive surgery.

Conclusion

CPC had 8.8 % neonatal mortality. Pouch excision and definitive procedure are feasible in neonates with CPC. Coloplasty in CCPC may result in postoperative colonic dilatation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Holschneider A, Hutson J, Peña A, Beket E, Chatterjee S, Coran A, Davies M, Georgeson K, Grosfeld J, Gupta DK et al (2005) Preliminary report on the international conference for the development of standards for the treatment of anorectal malformations. Jour Pediatr Surg. 10:1521–1526

    Article  Google Scholar 

  2. Gupta DK, Sharma S (2006). Congenital Pouch Colon, in Anorectal Malformations, 1st Edition, Ed. John Hutson and Alex Holschneider, Springer Heidelberg. 2006 Chapter 11, pp 211–222

  3. Gupta DK (2007) Congenital short colon: present lacunae. J Indian Assoc Pediatr Surg 12:1–2

    Article  Google Scholar 

  4. Gupta DK, Sharma S (2007) Congenital pouch colon—then and now. J Indian Assoc Pediatr Surg 12:5–12

    Article  Google Scholar 

  5. Al-Salem AH (2008) Unusual variants of congenital pouch colon with anorectal malformations. J Pediatr Surg 43:2096–2098

    Article  PubMed  Google Scholar 

  6. Mathur P, Prabhu K, Jindal D (2002) Unusual presentations of pouch colon. J Pediatr Surg 37:1351–1353

    Article  CAS  PubMed  Google Scholar 

  7. Frykman PK, Felder S, Zhai S (2013) Laparoscopic assisted anorectal pull-through for treatment of congenital pouch colon: two cases in central China. J Pediatr Surg Case Rep 1:343–347

    Article  Google Scholar 

  8. Atabek C, Demirbag S, Surer I et al (2007) Congenital pouch colon: is it really a rare pathology? Turk J Gastroenterol 18:261–264

    PubMed  Google Scholar 

  9. Lopater J, Hery G, Haddad M, Ughetto F, Gorincour G, Fernandez C et al (2010) Congenital pouch colon: antenatal diagnosis and video-assisted management. Pediatr Surg Int 26:759–761

    Article  PubMed  Google Scholar 

  10. Donkol RH, Jetley NK, Al Mazkary MH (2008) Congenital pouch colon syndrome in a Saudi Arabian neonate. J Pediatr Surg 43:e9–e11

    Article  PubMed  Google Scholar 

  11. Ghritlaharey RK, Budhwani KS, Shrivastava DK et al (2007) Experience with 40 cases of congenital pouch colon. J Indian Assoc Pediatr Surg 12:13–16

    Article  Google Scholar 

  12. Pavai A, Pillai S, Shanthakumari S, Sam C, Shylaja M, Sabarivinoth R (2009) Congenital pouch colon: Increasing association with low anorectal anomalies. J Indian Assoc Pediatr Surg 14:218–220

    Article  PubMed Central  PubMed  Google Scholar 

  13. Gangopadhyay AN, Chandrakant S, Patne U, Upadhyaya VD (2009) Congenital pouch colon associated with anorectal malformation—histopathologic evaluation. J Pediatr Surg 44:600–606

    Article  PubMed  Google Scholar 

  14. Gangopadhyay AN, Sharma S, Mohan TV, Gopal SC (2005) Single-stage management of all pouch colon (anorectal malformation) in newborns. J Pediatr Surg 40:1151–1155

    Article  CAS  PubMed  Google Scholar 

  15. Puri A, Chadha R, Choudhury SR, Garg A (2006) Congenital pouch colon: follow-up and functional results after definitive surgery. J Pediatr Surg 41:1413–1419

    Article  PubMed  Google Scholar 

  16. Sharma S, Gupta DK, Bhatnagar V, Bajpai M, Agarwala S (2005) Management of congenital pouch colon in association with ARM. J Indian Assoc Pediatr Surg 10:S22

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India

    Shilpa Sharma & Devendra K. Gupta

Authors
  1. Shilpa Sharma
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Devendra K. Gupta
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Devendra K. Gupta.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sharma, S., Gupta, D.K. Management options of congenital pouch colon—a rare variant of anorectal malformation. Pediatr Surg Int 31, 753–758 (2015). https://doi.org/10.1007/s00383-015-3739-3

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00383-015-3739-3

Keywords

Search

Navigation