Abstract

Background: Colonic atresia is the least frequent cause of neonatal intestinal obstruction; the estimated incidence is between 1.8 and 5.0% of all cases of intestinal atresia in the newborns or 1 in 40,000 live births. A type I case of colonic atresia in a newborn male is presented, undergoing a satisfactory post-surgical evolution.

Aim and Objectives: To report an unusual association  and its surgical resolution.

Methods/Study Design: Case report and literature revision. An 8 days old female baby is admitted to the emergency department with story of lack of stools, vomiting, abdominal distention and biliary  stained gastric liquid through orogastric tube.  An abdominal X –ray was taken, where hydro- aerial levels where evident along with intestinal distension  and no distal gas.

A barium contrast enema showed an unused or hypoplastic distal  colon with contrast not being able to pass beyond the level of the atresia

Results/Findings: A supra-umbilical transverse laparotomy  was performed showing a small diverticulum 25 cms. proximal to the ileocecal valve, proximal to the the ileocecal valve a dilated intestine loop was found, along with a colonic atresia type I,  20 cm distal to de ileocecal valve. The dilated  20 cm. segment was resected and a Foley catheter was passed distally. A two stoma ileostomy was  constructed.

Conclusion: Colonic atresia is a rare condition that requires a high suspicious index and a prompt medical and surgical approach.

Keywords: intestinal obstruction, colonic atresia, newborn.

References:

1. Congenital colonic stenosis: a case of late-onset. Ruggeri G, Libri M, Gargano T, Pavia S, Pasini L, Tani G, Lima M.Pediatr Med Chir. 2009 May-Jun; 31(3):130

2. Congenital colonic atresia: should primary anastomosis always be the goal? Watts AC, Sabharwal AJ, MacKinlay GA, Munro FD.Pediatr Surg Int. 2003 Apr; 19(1-2):14-7. Epub 2003 Mar 10.