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A Clinico-pathological Study of Colo-rectal Atresia

Background: For colorectal atresia, single stage operative procedure become more and more popular in many tertiary care center, especially, where frozen section biopsy is available. In this study, we aimed to highlight our experiences with seven cases colorectal atresias which were managed successfully with staged operative procedure in our institution during last 4 years.

Methods: A prospective study of colorectal atresia involved 7 patients (5 colonic atresias and 2 rectal atresias) admitted in a teaching hospital between June 1, 2013, and April 30, 2017. All patients were properly evaluated for associated anomalies before subjecting them to the final stage surgery (colostomy closure). The patients’ demographics, presenting symptoms, diagnostic studies, treatment options and complications, average length of hospital stay, time taken to complete the final surgery, associated anomalies and its managements and histopathology reports of rectal biopsy were considered.

Results: Five colonic atresias were treated by initial colostomy and rectal tissue biopsy then colostomy closure (two stage). Rectal atresias were treated by colostomy followed by posterior sagittal anorectoplasty then colostomy closure (three stage). One of the colonic atresia cases was associated with annular pancreas. One rectal atresia case was associated with presacral dermoid and rectovaginal fistula. None of our patients had associated Hirschsprung’s disease.

Conclusion: Timely diagnosis and management can be made if this condition is kept in mind while treating a case of neonatal intestinal obstruction. Single staged surgery should be avoided when emergency exploration is undertaken for intestinal obstruction. Irrespective of type of the atresia, staged surgery is most viable option for fruitful outcome, especially in developing countries.

Author(s): Pankaj Halder, Rajarshi Kumar, Kartik Chandra Mandal, Gobinda Mondal, Bidyut Debnath,Biswanath Mukhopadhyay,Bikram Mandal

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