2008 Volume 44 Issue 5 Pages 719-722
We herein report a case of antenatally suspected congenital colonic atresia. A full-term girl was born byvaginal delivery. Before delivery, neonatal ultrasonography showed isolated intestinal dilatation at the right lower quadrant at 33 weeks gestational age. We confirmed colonic atresia of the ascending colon with abdominal US and barium enema after her birth, and then an emergency operation was performed. The proximal colon was hugely dilated and there was marked discrepancy in the size of the proximal and distal colon either side of the atretic segment. A temporary colostomy was made at both ends of the colon. The distal colon was grown using continuous feeding of dietary fiber supplemented with saline. The anastomosis of the colon was made end to end on the 53rd day and the patient was discharged from the hospital at 74 days after birth. When primary anastomosis may not be safe, we would advocate a staged procedure to avoid significant loss of colon and Bauhin's valve. In addition, antenatal diagnosis has a significant importance in the management of colonic atresia since surgical management is needed immediately after the delivery.
