Abstract
A 3-day-old boy who was born at 41 weeks of gestation with a birth weight of 3,440 g developed bilious vomiting a day after birth. He was diagnosed as having colonic atresia by a contrast enema study that showed a microcolon, and surgery was performed. A type III colonic atresia was found and the proximal end of the atretic segment was located in the ascending colon 7 cm distal to the ileocecal valve. The bowel caliber ratio between the normal and atretic segment was 11 : 1. An ascending colostomy and tube enterostomy were performed. Postoperatively, the proximal colon was deflated and the distal colon was grown by feeding. At the anastomosis, the bowel caliber ratio was reduced to 2 : 1. The postoperative recovery was uneventful. Treatment for congenital colonic atresia differs depending on the type and condition of the colon at the time of the primary surgery. When the bowel caliber ratio is high, we advocate the use of a primary anastomosis with appendicostomy or tube enterostomy. If this is judged to be risky, a staged procedure should be performed, with the bowel caliber ratio reduced using a temporary colostomy.
