El-Asmar Khaled M, Abdel-Latif Mohammed, El-Kassaby Abdel-Hamid A, Soliman Mohamed H, El-Behery Mosad M
Pediatric Surgery Department, Ain Shams University, Cairo, Egypt.
Pediatric Surgery Division, Helwan University, Egypt.
J Neonatal Surg. 2016 Oct 10;5(4):47. doi: 10.21699/jns.v5i4.422. eCollection 2016 Oct-Dec.
Colonic atresia (CA) is a rare form of congenital intestinal atresia. Although CA may be isolated, it is more commonly reported in literature in association with other congenital anomalies.
This study is a review of prospectively collected data of all the patients with colonic atresia presented to our center (Ain Shams University) during 2008 to 2016.
Twelve patients were enrolled in this study. The atresia was of type I in one case, type II in four cases, type IIIa in six cases, type IV in one case. These cases accounted for 4.9 % of intestinal atresias managed in our center during the same period. Five cases were isolated CA, while the other seven cases had associated abdominal congenital anomalies (exomphalos, Hirschsprung's disease, imperforate anus, closing gastroschisis, colonic duplication, and multiple small bowel atresia in two cases). The management in ten cases was by staged procedure with creation of a temporary stoma initially, while primary anastomosis was established in two cases. We had two cases with delayed presentations, one missed diagnosis, and three mortalities in this series.
The low incidence of CA may result in delay in the diagnosis and management. Hirschsprung's disease should be excluded in every case of colonic atresia. Early diagnosis and proper surgical management is essential for good prognosis.
结肠闭锁（CA）是一种罕见的先天性肠道闭锁形式。虽然CA可能是孤立存在的，但在文献中更常报道其与其他先天性异常相关。
本研究回顾了2008年至2016年期间在我们中心（艾因夏姆斯大学）就诊的所有结肠闭锁患者的前瞻性收集数据。
本研究纳入了12例患者。闭锁类型为I型1例，II型4例，IIIa型6例，IV型1例。这些病例占同期在我们中心处理的肠道闭锁病例的4.9%。5例为孤立性CA，另外7例伴有腹部先天性异常（脐膨出、先天性巨结肠、肛门闭锁、闭合性腹裂、结肠重复畸形，2例伴有多处小肠闭锁）。10例患者的治疗采用分期手术，最初造一个临时造口，2例进行了一期吻合。本系列中有2例延迟就诊，1例漏诊，3例死亡。
CA的低发病率可能导致诊断和治疗延迟。每例结肠闭锁患者均应排除先天性巨结肠。早期诊断和恰当的手术治疗对良好预后至关重要。
