A Case of Congenital Colonic Atresia With Heal Stenosis

Takenouchi Ayako, Yoshida Hideo, Matsunaga Tadao, Kouchi Katsunori, Ohtsuka Yasuhiro, Okada Tadao, Sasaki Kou, Nakata Mitsuyuki, Ohnuma Naomi

doi:10.11164/jjsps.40.7_884

A case of congenital colonic atresia with ileal stenosis is reported. A one-day-old boy was referred to our institution with abdominal distension and vomiting. Plain abdominal X-ray showed a hugely dilated loop in the right upper abdomen. A barium enema showed microcolon. During surgery, membranous stenosis of the ileum and type III atresia of the ascending colon were noted. The stenotic ileum was resected and anastomosed, and colostomy was constructed at the site of colonic atresia. At 3 months of age, colostomy was closed by anastomosing the site of atresia between the ascending colon and transverse colon. However, he underwent re-anastomosis 2 times because of anastomotic stricture. We reviewed 126 cases of colonic atresia in the Japanese literature. Atresias in the descending and sigmoid region should not be treated by primary anastomosis because the proximal colon is hugely dilated in general. It is difficult to preserve the ileocecal valve in the atresias proximal to the splenic flexure generally; however, delayed-primary anastomosis and decompression by tube enterostomy may increase the chance for preserving the ileocecal valve. In addition, in cases with associated birth defects, such as ileal stenosis or atresia, colostomy is recommended.

A Case of Congenital Colonic Atresia With Heal Stenosis

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