Colonic atresia and stenosis: our experience.

Area of Science:

• Pediatric Surgery
• Gastrointestinal Surgery
• Congenital Malformations

Background:

• Colonic atresia and stenosis are exceedingly rare conditions.
• Fewer than 10 cases of colonic stenosis have been reported.
• Colonic atresia occurs at a rate of approximately 1 case per year in pediatric surgical centers.

Purpose of the Study:

• To review the management and outcomes of pediatric colonic atresia and stenosis.
• To evaluate surgical techniques and associated factors influencing prognosis.

Main Methods:

• Retrospective review of medical records for patients treated between March 2006 and March 2010.
• Analysis of 15 patients diagnosed with colonic atresia (11) or stenosis (4).

Main Results:

• Colonic atresias occurred in the ascending colon (4), hepatic flexure (2), transverse colon (2), and sigmoid colon (1).
• Colonic stenosis affected the transverse colon (2) and sigmoid colon (2), with two congenital and two secondary to necrotizing enterocolitis.
• Colonic atresias were managed with colocolic anastomosis and covering ileostomy (8) or exteriorization (3); stenosis cases underwent primary or ileostomy-covered anastomosis.
• Three patients with colonic atresia died postoperatively.

Conclusions:

• Colonic atresia and stenosis are rare pediatric surgical emergencies.
• The presence of associated alimentary tract malformations is linked to a poorer prognosis.
• Colocolic anastomosis with a covering ileostomy is a safe and effective management strategy for colonic atresia.