2025 Volume 61 Issue 2 Pages 208-213
We report a case of congenital colonic atresia with stenosis surrounding the atresia site, where no clear blood flow was observed during surgery. Multiple surgeries were required owing to challenges in determining the resection range. The patient had gastrointestinal perforation on the first day of life and underwent emergency surgery. This revealed perforation of the ascending colon, type II atresia in the descending colon, and stenosis around the atresia site. A double-barrel ileostomy and a single-barrel colostomy proximal to the atresia site were performed. The patient was also diagnosed as having cystic biliary atresia and underwent hepatojejunostomy. Despite intestinal rehabilitation by pseudostool injection, the stenotic segments did not grow. However, during surgery, it was difficult to determine whether these segments were organic lesions, necessitating multiple additional resections. Retrospective analysis linked the stenotic areas to the inferior mesenteric artery region. Histopathological analysis revealed submucosal fibrosis consistent with ischemic changes, suggesting blood flow disturbance as the primary issue. In cases of colonic atresia with proximal stenosis, blood flow disturbance should be considered. The extent of intestinal resection should be based on the response to pseudostool injection and histopathological findings.
