title: Huge Congenital Segmental Dilatation of the Sigmoid Colon in a Neonate: A "Rarity to Meet" and a "Challenge to Treat".
abstract: Only ten cases of neonatal congenital segmental dilatation (CSD) of the colon have been described so far. We present a full-term female newborn with trisomy 21, ventricular septal defect, and gross abdominal distension. Plain abdominal radiographs revealed a huge cystic lesion occupying the left hemiabdomen. Upon laparotomy on day 4 a CSD of the distal sigmoid and proximal rectum was confirmed and resected. The proximal colon was exteriorized and the distal part closed as a Hartmann pouch. Histology confirmed a huge segmental dilatation of the sigmoid without dysganglionosis or pseudodiverticula, but normal intestinal architecture. After correction of the ventricular septal defect a low rectal end-to-end anastomosis could be performed at an age of 5 months. The postoperative course was uneventful. CSD of the sigmoid colon is extremely "rare to meet" and a "challenge to treat" in the newborn period, but clinical awareness of this entity prompts pediatric surgical success.
authors.affiliation: Department of Pediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria.
authors.forename: Margarita
authors.initials: M
authors.lastname: Kaiser
authors.affiliation: Department of Pediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria.
authors.forename: Christoph
authors.identifier: 0000-0002-4512-3640
authors.initials: C
authors.lastname: Castellani
authors.affiliation: Department of Pediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria.
authors.forename: Georg
authors.identifier: 0000-0003-4770-3144
authors.initials: G
authors.lastname: Singer
authors.affiliation: Division of Pediatric Radiology, Medical University Graz, Auenbruggerplatz 34, 8036 Graz, Austria.
authors.forename: Robert
authors.identifier: 0000-0001-6806-122X
authors.initials: R
authors.lastname: Marterer
authors.affiliation: Institute of Pathology, Medical University of Graz, Auenbruggerplatz 25, 8036 Graz, Austria.
authors.forename: Manfred
authors.initials: M
authors.lastname: Ratschek
authors.affiliation: Department of Pediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria.
authors.forename: Holger
authors.initials: H
authors.lastname: Till