Congenital pouch colon

Chadha, Ritu; Khan, Niyaz Ahmed

doi:10.4103/jiaps.jiaps_5_17

Cited by 31 publications

(40 citation statements)

References 37 publications

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“…[1] In most descriptions, CPC in male children presented with absent anal opening and had communication with the genitourinary tract. [45] In our study also, while the most common presentation was similar to that described in the literature, i.e., absent anal opening and colovesical communication, 15 children presented in a different manner, and consequently, the management was also different.…”

Section: Discussionsupporting

confidence: 83%

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Type IV congenital pouch colon in male children: Anatomical variations and a proposed new subclassification

Solanki

Menon

Nayak

et al. 2020

J Indian Assoc Pediatr Surg

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Background:Congenital pouch colon (CPC) is a rare variant of anorectal malformation. In male patients, CPC communicates distally with the urogenital tract by a large fistula. The CPC cases which do not fulfill the criteria as mentioned in the classical description are reported along with the pertinent literature review.Materials and Methods:This was a retrospective study from January 2004 to December 2017 of male children with Type IV CPC. We evaluated clinical presentation, primary management, anatomical relationship, previous surgical intervention, definitive management, result, and outcome in terms of continence status on Templeton score.Results:Fifty-one children were included in the study among whom 36 children (Group 1) had a colovesical fistula and 15 children (Group 2) had no communication of the pouch with the genitourinary tract. In Group 2 children, the clinical presentations and management were varied: 4 underwent primary pull-through procedure, whereas 11 underwent staged procedure. Group 2 included three children in whom a narrow and thin-walled anal canal or anal canal with lower rectum was present, which was incorporated during the pull-through procedure. On continence assessment, only one child in Group 1 had “good” continence score compared to four children (three having anal canal) in Group 2.Conclusion:CPC Type IV can present without genitourinary tract communication (fistula), contrary to its emblematic description. Awareness about anatomical variations and adaptation of surgical technique accordingly is vital. The identification of the anal canal with or without the lower part of the rectum (even though apparently narrow and thin walled) and incorporation of this in bowel continuity lead to better outcomes in terms of continence.

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Section: Discussionsupporting

confidence: 83%

“…In males, the pouch usually terminates in a colovesical fistula just proximal to the bladder neck. [14] CPC has been included, as a rare variant, in the Krickenbeck classification of ARM. A recent review showed that about 90% of reported cases in the world were from India.…”

Section: Introductionmentioning

confidence: 99%

Type IV congenital pouch colon in male children: Anatomical variations and a proposed new subclassification

Solanki

Menon

Nayak

et al. 2020

J Indian Assoc Pediatr Surg

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“…Sacral agenesis, bilateral vesicoureteric reflux and cyanotic congenital heart diseases were the most common associated congenital anomalies. The mortality rate may reach 10–15% after surgical intervention [19,20].…”

Section: Discussionmentioning

confidence: 99%

Congenital pouch colon in Duhok, outcome and complications: Case series

Qadir

Mohammed

2019

Annals of Medicine and Surgery

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Background Congenital pouch colon (CPC) is a rare congenital abnormality associated with anorectal malformations with high incidence of complications and mortality. The aim of this study is to describe the various types of congenital colon pouch, their management aspects, complications of surgery, and the best management options. Results The incidence of congenital pouch colon in the present study was 5.3% (18 patients) of all anorectal malformations. Sixteen cases (88.8%) were males and 2 cases (12.5%) were females, (M: F ratio was 8:1). The age of presentation was ranged from 1day to 1year; 17 cases were presented in first week of life. Preoperative diagnosis of congenital pouch colon was done in 7 patients. As an initial procedure tabularization of the pouch with end colostomy was done in 15 cases, window colostomy was done in 2 cases, and excision of the pouch and proximal ileostomy was done in one patient. As a definitive procedure, abdomino-perineal pull-through of the tabularized pouch was done in 15 cases, ileo-anal anastomosis after pouch excision was done in 3 cases. Conclusions Pouch tabularization and end colostomy had better outcome than other types of interventions. Abdomino-perineal pull through of the tabularized pouch was the definitive surgical procedure for treatment of complete pouch colon in our study.

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“…The association of pouch colon anomaly with VUR has previously been defined in various studies,[ 1 2 ] but the exact incidence is still not known. Associated genitourinary system anomalies were seen in 20/56 patients (35.71%), of which VUR was seen in all six patients who underwent cystourethrogram; in rest of the 50 patients, cystourethrogram was not done.…”

Section: Discussionmentioning

confidence: 99%

“…C ongenital pouch colon (CPC) syndrome is a rare variant of high anorectal malformation in which there is a complete absence of the rectum and variable length of the colon terminating in a dilated pouch that most commonly opens directly into the bladder through a wide fistula. [ 1 ] Based on the length of the colon, there are four types. About 37.46% of patients of CPC have associated genitourinary anomalies, among which vesicoureteric reflux (VUR) accounts for almost 17%.…”

Section: Introductionmentioning

confidence: 99%

Abdominoperineal pull-through with simultaneous extravesical detrussoraphy: An alternative surgical technique for congenital pouch colon with high-grade vesicoureteric reflux

Bawa

Garg

Dash

et al. 2018

J Indian Assoc Pediatr Surg

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Congenital pouch colon (CPC) is frequently associated with vesicoureteric reflux (VUR). These patients require long-term antibiotic prophylaxis and/or an additional surgical intervention for the management of the refluxing system. We propose a single-stage alternative approach in these patients. Two patients diagnosed to have CPC underwent pouch excision and an end colostomy at birth. Further evaluation revealed high-grade reflux in both the patients. At 6 months of age, definitive abdominoperineal pull-through (APPT) surgery along with extravesical detrusorrhaphy was performed. In the follow-up at 1 year, they are thriving well with no urinary complaints. Micturating cystourethrogram revealed complete resolution of VUR. This approach takes the advantage of the anesthesia for APPT and offers a relatively simple and quick solution for the refluxing system, thus, enabling the stoppage of antibiotic prophylaxis and obviating the need for a future endoscopy/surgery.

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Congenital pouch colon

Cited by 31 publications

References 37 publications

Type IV congenital pouch colon in male children: Anatomical variations and a proposed new subclassification

Type IV congenital pouch colon in male children: Anatomical variations and a proposed new subclassification

Congenital pouch colon in Duhok, outcome and complications: Case series

Abdominoperineal pull-through with simultaneous extravesical detrussoraphy: An alternative surgical technique for congenital pouch colon with high-grade vesicoureteric reflux

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