Congenital multiple colonic atresias with intestinal malrotation: a case report
Abstract Background Congenital intestinal atresia develops in 1 in 1500 to 20,000 births. Colonic atresia, which accounts for 1.8–15% of intestinal atresia cases, is accompanied by other gastrointestinal atresias such as small intestinal atresia, gastroschisis, imperforate anus, and intestinal malfo...
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Japan Surgical Society
2020-03-01
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| Series: | Surgical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s40792-020-00822-z |
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| author | Daisuke Ishii Hisayuki Miyagi Masatoshi Hirasawa Kazutoshi Miyamoto |
| author_facet | Daisuke Ishii Hisayuki Miyagi Masatoshi Hirasawa Kazutoshi Miyamoto |
| author_sort | Daisuke Ishii |
| collection | DOAJ |
| description | Abstract Background Congenital intestinal atresia develops in 1 in 1500 to 20,000 births. Colonic atresia, which accounts for 1.8–15% of intestinal atresia cases, is accompanied by other gastrointestinal atresias such as small intestinal atresia, gastroschisis, imperforate anus, and intestinal malformation in 47–80%. Although a report shows that patients with multiple colonic atresias are 8.9% of those with colonic atresia. Case presentation A male infant did not have the first bowel movement within 36 h of birth and had abdominal distention/vomiting. Radiography showed significant dilation of the intestinal tract. A contrast enema examination at 3 days of age showed a microcolon and disruption in the descending colon. We performed an emergency decompressive loop enterostomy in the distended segment. At the age of 7 months, imaging from the stoma showed disruption of the contrast medium in the intestinal tract at the right lower abdomen, and the continuity of the intestinal tract was not clarified. Intestinal malrotation was found during the second surgery, and the enterostomy was located in the ileum proximal to Bauhin’s valve. Continuity of the intestinal serosal surface was maintained. However, multiple membranous obstructions (three atresias and one stenosis) were observed in the distal segment of the bowel, which was penetrated by intraluminal advancement of a urethral catheter. Therefore, he was diagnosed with multiple colonic atresias. The intestinal tract was longitudinally incised, and membranectomy and mucosal/lateral suture were performed. Conclusions It is important for neonates with intestinal atresia to evaluate and prepare for distal patency of the colon before radical anastomosis. In addition, anomalies associated with colon atresia should also be assessed. |
| format | Article |
| id | doaj-art-68d2b89414b64dd4bbf4a139c8ef5ebb |
| institution | DOAJ |
| issn | 2198-7793 |
| language | English |
| publishDate | 2020-03-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-68d2b89414b64dd4bbf4a139c8ef5ebb2025-08-20T02:52:30ZengJapan Surgical SocietySurgical Case Reports2198-77932020-03-01611510.1186/s40792-020-00822-zCongenital multiple colonic atresias with intestinal malrotation: a case reportDaisuke Ishii0Hisayuki Miyagi1Masatoshi Hirasawa2Kazutoshi Miyamoto3Department of Pediatric Surgery, Asahikawa Medical UniversityDepartment of Pediatric Surgery, Asahikawa Medical UniversityDepartment of Pediatric Surgery, Asahikawa Medical UniversityDepartment of Pediatric Surgery, Asahikawa Medical UniversityAbstract Background Congenital intestinal atresia develops in 1 in 1500 to 20,000 births. Colonic atresia, which accounts for 1.8–15% of intestinal atresia cases, is accompanied by other gastrointestinal atresias such as small intestinal atresia, gastroschisis, imperforate anus, and intestinal malformation in 47–80%. Although a report shows that patients with multiple colonic atresias are 8.9% of those with colonic atresia. Case presentation A male infant did not have the first bowel movement within 36 h of birth and had abdominal distention/vomiting. Radiography showed significant dilation of the intestinal tract. A contrast enema examination at 3 days of age showed a microcolon and disruption in the descending colon. We performed an emergency decompressive loop enterostomy in the distended segment. At the age of 7 months, imaging from the stoma showed disruption of the contrast medium in the intestinal tract at the right lower abdomen, and the continuity of the intestinal tract was not clarified. Intestinal malrotation was found during the second surgery, and the enterostomy was located in the ileum proximal to Bauhin’s valve. Continuity of the intestinal serosal surface was maintained. However, multiple membranous obstructions (three atresias and one stenosis) were observed in the distal segment of the bowel, which was penetrated by intraluminal advancement of a urethral catheter. Therefore, he was diagnosed with multiple colonic atresias. The intestinal tract was longitudinally incised, and membranectomy and mucosal/lateral suture were performed. Conclusions It is important for neonates with intestinal atresia to evaluate and prepare for distal patency of the colon before radical anastomosis. In addition, anomalies associated with colon atresia should also be assessed.http://link.springer.com/article/10.1186/s40792-020-00822-zColonic atresiaMultipleIntestinal malrotationMicrocolon |
| spellingShingle | Daisuke Ishii Hisayuki Miyagi Masatoshi Hirasawa Kazutoshi Miyamoto Congenital multiple colonic atresias with intestinal malrotation: a case report Surgical Case Reports Colonic atresia Multiple Intestinal malrotation Microcolon |
| title | Congenital multiple colonic atresias with intestinal malrotation: a case report |
| title_full | Congenital multiple colonic atresias with intestinal malrotation: a case report |
| title_fullStr | Congenital multiple colonic atresias with intestinal malrotation: a case report |
| title_full_unstemmed | Congenital multiple colonic atresias with intestinal malrotation: a case report |
| title_short | Congenital multiple colonic atresias with intestinal malrotation: a case report |
| title_sort | congenital multiple colonic atresias with intestinal malrotation a case report |
| topic | Colonic atresia Multiple Intestinal malrotation Microcolon |
| url | http://link.springer.com/article/10.1186/s40792-020-00822-z |
| work_keys_str_mv | AT daisukeishii congenitalmultiplecolonicatresiaswithintestinalmalrotationacasereport AT hisayukimiyagi congenitalmultiplecolonicatresiaswithintestinalmalrotationacasereport AT masatoshihirasawa congenitalmultiplecolonicatresiaswithintestinalmalrotationacasereport AT kazutoshimiyamoto congenitalmultiplecolonicatresiaswithintestinalmalrotationacasereport |