Congenital colonic atresia: should primary anastomosis always be the goal?
We report 4 cases of the rare condition, congenital colonic atresia, presenting over 9 years. Two patients had dilated loops of bowel noted on routine ante-natal ultrasound. Three had primary anastomosis for lesions in transverse or distal descending colon and one had a staged procedure with colostomy formation. All had type III atresia. One patient had an early leak following primary colo-colic anastomosis for atresia extending from the hepatic flexure to the sigmoid colon. If it is desired to preserve the proximal colon in a right sided lesion with significant loss of colonic length then primary anastomosis may not be safe and we would advocate a staged procedure. Otherwise we would support current moves towards primary anastomosis in this condition. We also urge early investigation in all patients who exhibit intestinal dilatation on antenatal ultrasound.
Watts
A C
AC
Department of Pediatric Surgery, Royal Hospital for Sick Children, Sciennes Road, Edinburgh EH9 1LF.
Sabharwal
A J
AJ
MacKinlay
G A
GA
Munro
F D
FD
D000714:Anastomosis, Surgical; D003108:Colonic Diseases / Q000151:congenital / Q000601:surgery*; D003125:Colostomy; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007409:Intestinal Atresia / Q000601:surgery*; D008297:Male