Favorable Outcome Following Staged Surgery With Umbilical Colostomy

Abstract

We present the case of a one-day-old girl who was brought to the hospital owing to postnatal symptoms, including mucous-like defecation upon anal stimulation and bilious vomiting six hours after birth. The patient was admitted to our hospital with abdominal distention; plain abdominal X-ray imaging and gastrografin enema revealed intestinal dilatation and microcolon, respectively. Laparotomy was performed via a transverse right upper abdominal incision; this revealed a completely dissected colonic atresia and a microcolon below the splenic flexure in the ascending colon, with no evidence of intestinal atresia elsewhere. Although the difference in caliber was over 1:10, a diamond anastomosis was performed and an umbilical ileal loop ostomy was created as a diverting stoma. The patient was readmitted to the hospital four months after the surgery. After confirming the improvement of the anastomotic caliber difference, the patient underwent stoma closure and umbilical plasty, and the postoperative course was good. Thus, we present a unique case of a successful staged surgery involving the complete dissection of the ascending colon obstruction and umbilical ileostomy. The surgery was safely completed while maintaining a good cosmetic appearance, and the patient had a favorable outcome.