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.
Department of Pediatric Surgery, Royal Hospital for Sick Children, Sciennes Road, Edinburgh EH9 1LF.
A C
AC
Watts
A J
AJ
Sabharwal
G A
GA
MacKinlay
F D
FD
Munro
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