Pediatric Surgery International

, Volume 31, Issue 8, pp 753–758 | Cite as

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

  • Shilpa Sharma
  • Devendra K. GuptaEmail author
Original Article



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


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


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.


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.


Pouch colon Complete Incomplete Coloplasty Anorectal malformation 


  1. 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. 10:1521–1526CrossRefGoogle Scholar
  2. 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 211–222Google Scholar
  3. 3.
    Gupta DK (2007) Congenital short colon: present lacunae. J Indian Assoc Pediatr Surg 12:1–2CrossRefGoogle Scholar
  4. 4.
    Gupta DK, Sharma S (2007) Congenital pouch colon—then and now. J Indian Assoc Pediatr Surg 12:5–12CrossRefGoogle Scholar
  5. 5.
    Al-Salem AH (2008) Unusual variants of congenital pouch colon with anorectal malformations. J Pediatr Surg 43:2096–2098PubMedCrossRefGoogle Scholar
  6. 6.
    Mathur P, Prabhu K, Jindal D (2002) Unusual presentations of pouch colon. J Pediatr Surg 37:1351–1353PubMedCrossRefGoogle Scholar
  7. 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 1:343–347CrossRefGoogle Scholar
  8. 8.
    Atabek C, Demirbag S, Surer I et al (2007) Congenital pouch colon: is it really a rare pathology? Turk J Gastroenterol 18:261–264PubMedGoogle Scholar
  9. 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 26:759–761PubMedCrossRefGoogle Scholar
  10. 10.
    Donkol RH, Jetley NK, Al Mazkary MH (2008) Congenital pouch colon syndrome in a Saudi Arabian neonate. J Pediatr Surg 43:e9–e11PubMedCrossRefGoogle Scholar
  11. 11.
    Ghritlaharey RK, Budhwani KS, Shrivastava DK et al (2007) Experience with 40 cases of congenital pouch colon. J Indian Assoc Pediatr Surg 12:13–16CrossRefGoogle Scholar
  12. 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 14:218–220PubMedCentralPubMedCrossRefGoogle Scholar
  13. 13.
    Gangopadhyay AN, Chandrakant S, Patne U, Upadhyaya VD (2009) Congenital pouch colon associated with anorectal malformation—histopathologic evaluation. J Pediatr Surg 44:600–606PubMedCrossRefGoogle Scholar
  14. 14.
    Gangopadhyay AN, Sharma S, Mohan TV, Gopal SC (2005) Single-stage management of all pouch colon (anorectal malformation) in newborns. J Pediatr Surg 40:1151–1155PubMedCrossRefGoogle Scholar
  15. 15.
    Puri A, Chadha R, Choudhury SR, Garg A (2006) Congenital pouch colon: follow-up and functional results after definitive surgery. J Pediatr Surg 41:1413–1419PubMedCrossRefGoogle Scholar
  16. 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:S22Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Department of Pediatric SurgeryAll India Institute of Medical SciencesNew DelhiIndia

Personalised recommendations