Abstract
Fourteen cases of colonic atresia seen over a 38-year period are reviewed with particular reference to clinical presentation and pitfalls in management. Seven had Type I atresia, two Type II and five Type IIIa. Ten had associated gastrointestinal anomalies. Management varied considerably. Six had primary colonic anastomosis. Two of these developed complications due to unrecognized distal hypoganglionosis, two had associated jejunal atresias resulting in short bowel syndrome, and two had primary anastomosis protected by proximal ileostomies. Seven had a staged repair with initial defunctioning enterostomy with only one complication, an unfixed mesentery that later resulted in midgut volvulus. The only mortality was a patient in which a jejunal atresia repair leaked as a result of a missed colonic atresia. Operative strategy should depend on the clinical state of the patients, the level of atresia, associated small bowel pathology and exclusion of distal pathology. Primary anastomosis would only rarely be advised with a circumspect approach. Long-term outlook, as in small bowel atresia is generally excellent.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Millar AJW, Rode H, Cywes S (2000) Intestinal atresia and stenosis, 3rd Edition. Pediatr Surg Ashcraft 30:406–424
Boles ET, Vassy LE, Ralston M (1976) Atresia of the colon. J Pediatr Surg 11(1):69–75
Landes A, Schuckett B (1994) Non-fixation of the colon in colonic atresia: a new finding. Pediatr Radiol 24:167–169
Davenport M, Bianchi A, Doig CM, Gough CS (1990) Colonic atresia: current results of treatment. J R Coll Surg Edin. 35(1):25–28
Pohlson EC, Hatch EI, Glick PL, Tapper D (1988) Individualized management of colonic atresia. Am J Surg 155:690–692
Dalla Vecchia LK, Grosfeld JL, West KW, Rescorla FJ, Scherer LR, Engum SA (1998) Intestinal atresia and stenosis a 25 year experience with 277 cases. Arch Surg 133:490–496
Harbour MJ, Altman DH, Gilbert M (1965) Congenital atresia of the colon. Radiol 84:19–23
Harris J, Kallen B, Robert E (1995) Descriptive epidemiology of alimentary tract atresia. Teratology 52:15–29
Louw JH, Barnard CN (1955) Congenital intestinal atresia: observations on its origin. Lancet ii:1065–1067
Erskine JM (1970) Colonic stenosis in the newborn: the possible thromboembolic aetiology of intestinal stenosis and atresia. J Pediatr Surg 5(3):321–333
Benson CD, Lotf MW, Brough AJ (1968) Congenital atresia and stenosis of the colon. J Pediatr Surg 3(2):253–257
Kim PCW, Superina RA, Ein E (1995) Colonic atresia combined with Hirschsprung’s disease: a diagnostic and therapeutic challenge. J Pediatr Surg 30: 1216–1217
Akgur FM, Tanyel FC, Büyükpamukçu N, Hiçsönmez A (1993) Colonic atresia and Hirschsprung’s disease association shows further evidence for migration of the enteric neurons. J Pediatr Surg 26(4):635–636
Moore SW, Rode H, Millar AJW, Cywes S (1990) Intestinal atresia and Hirschsprung’s disease. Pediatr Surg Int 5:182–184
Fishman SJ, Islam S, Buonomo C, Nurko S (2001) Non-fixation of an atretic colon predicts Hirschsprung’s disease. J Pediatr Surg 36(1):202–204
Karnak I, Çiftçi AO, Senocak ME, Tanyel FC, Büyükpamukçu N (2001) Colonic atresia: surgical management and outcome. Pediatr Surg Int 17(8):631–635
Author information
Authors and Affiliations
Corresponding author
Additional information
An erratum to this article can be found at http://dx.doi.org/10.1007/s00383-005-1568-5
Rights and permissions
About this article
Cite this article
Cox, S., Numanoglu, A., Millar, A. et al. Colonic atresia: spectrum of presentation and pitfalls in management. A review of 14 cases. Ped Surgery Int 21, 813–818 (2005). https://doi.org/10.1007/s00383-005-1488-4
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00383-005-1488-4