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Original Article

Clinical Experience with Colonic Atresia

Jihee Hwang, M.D., Dae-Yeon Kim, M.D., Seong-Chul Kim, M.D., In-Koo Kim, M.D.1
Journal of the Korean Association of Pediatric Surgeons 2012;18(2):68-74.
Published online: December 31, 2012

Division of Pediatric Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

1Division of Pediatric Surgery, GangNeung Asan Hospital, GangNeung, Korea.

Correspondence: Seong-Chul Kim, M.D., Division of Pediatric Surgery, Asan Medical Center, Asanbyeongwon-gil 86, Sonpa-gu, Seoul 138-736, Korea. Tel: 02)3010-3498, Fax: 02)474-6701, sckim@amc.seoul.kr
• Received: September 26, 2012   • Accepted: November 15, 2012

Copyright © 2012 Korean Association of Pediatric Surgeons

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  • Colonic atresia (CA) is the rare cause of intestinal obstruction, and diagnosis of CA is difficult. But only few research has been performed, so little information has been available. The purposes of this study was to analyze the clinical findings of CA so that help physicians make decision properly. Children with CA who were treated at the division of pediatric surgery at Asan Medical Center in the period from January 1989 to December 2011 were evaluated retrospectively. A total of 6 children were treated with CA. These accounted for 2.7% of all gastrointestinal atresias managed in Asan Medical Center. Only one child was premature and low birth weight, the others were fullterm neonates and showed normal birth weight. Vomiting and abdominal distension were common symptoms and simple X-ray and barium study were used for diagnose of CA. But only 66.7% of the babies were diagnosed as CA pre-operatively. And 2 children out of 6 underwent re-operation due to missed CA at the time of the first operation. In aspect of types of atresia, the type IIIa were two, type IV were two, type I was one case, and one child showed rectal stenosis due to rectal web. Various operations were done according to individual findings and associated diseases. The 50% (n=3) of children underwent the primary anastomosis and the others (n=3) underwent colostomy first and staged operation later for missed CA or associated disease. All of them were recovered any significant complications. Therefore, the prognosis of CA is satisfactory if diagnosis and surgical management could be made properly. But because of the low incidence of CA, delay of diagnosis and treatment may occur. To prevent delay of diagnosis, we suggest prompt evaluation of doubtful infant and careful inspection of distal patency of bowel including whole colon and rectum when operating patients with intestinal atresia at any level.
  • Keywords: Colon; Atresia; Diagnosis
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Fig. 1
Image of simple X-ray at the age of 8days (Case No. 3).
jkaps-18-68-g001.jpg
Fig. 2
Image of barium enema at the age of 8days (Case No. 3).
The contrast cannot advance further.
jkaps-18-68-g002.jpg
Fig. 3
Image of simple X-ray at the age of 43days (Case No. 4).
jkaps-18-68-g003.jpg
Fig. 4
Image of barium enema at the age of 43days (Case No. 4).
The contrast cannot advance further.
jkaps-18-68-g004.jpg
Fig. 5
Image of barium enema at the age of 5years (Case No. 6).
jkaps-18-68-g005.jpg
Table 1
Clinical Presentation and Treatment focused on Colonic Atresia

Age*: Age at proper diagnosis

Delayed BE**: BE was performed at the age of 43days.

Abbreviations: CA; colonic atresia, JA; jejunal atresia, ARM ;anorectal malformation, BE; barium enema, R & A; resection and anastomosis, C; colostomy and later take-down, LAR; low anterior resection.

jkaps-18-68-i001.jpg

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Clinical Experience with Colonic Atresia
J Korean Assoc Pediatr Surg. 2012;18(2):68-74.   Published online December 31, 2012
DOI: https://doi.org/10.0000/jkaps.2012.18.2.68
Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
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Include:
Clinical Experience with Colonic Atresia
J Korean Assoc Pediatr Surg. 2012;18(2):68-74.   Published online December 31, 2012
DOI: https://doi.org/10.0000/jkaps.2012.18.2.68
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Clinical Experience with Colonic Atresia
Image Image Image Image Image
Fig. 1 Image of simple X-ray at the age of 8days (Case No. 3).
Fig. 2 Image of barium enema at the age of 8days (Case No. 3). The contrast cannot advance further.
Fig. 3 Image of simple X-ray at the age of 43days (Case No. 4).
Fig. 4 Image of barium enema at the age of 43days (Case No. 4). The contrast cannot advance further.
Fig. 5 Image of barium enema at the age of 5years (Case No. 6).

Fig. 1

Fig. 2

Fig. 3

Fig. 4

Fig. 5

Clinical Experience with Colonic Atresia

Clinical Presentation and Treatment focused on Colonic Atresia

Age*: Age at proper diagnosis

Delayed BE**: BE was performed at the age of 43days.

Abbreviations: CA; colonic atresia, JA; jejunal atresia, ARM ;anorectal malformation, BE; barium enema, R & A; resection and anastomosis, C; colostomy and later take-down, LAR; low anterior resection.

Table 1 Clinical Presentation and Treatment focused on Colonic Atresia

Age*: Age at proper diagnosis

Delayed BE**: BE was performed at the age of 43days.

Abbreviations: CA; colonic atresia, JA; jejunal atresia, ARM ;anorectal malformation, BE; barium enema, R & A; resection and anastomosis, C; colostomy and later take-down, LAR; low anterior resection.

Table 1

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