Rectal Atresia Treated Via a Transanal and Posterior Sagittal Approach: A Report of Two Cases

Kurashima, Maho; Joshi, Samrudhi; Sobrino, Justin; Blewett, Christopher

doi:10.7759/cureus.38694

Cited by 3 publications

(1 citation statement)

References 19 publications

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“…The incidence of anastomotic stenosis following colorectal stapling surgery ranges between 3-30%, which is challenging to manage using conventional approaches (e.g., open surgery and colonoscopy) ( 6 ). Severe anastomotic stenosis, to a certain extent, can lead to anastomotic closure, which is classified as the most severe category of anastomotic stenosis, resulting in only a small gap or complete occlusion ( 7 , 8 ). The precise cause of anastomotic stenosis and occlusion remains unknown and may be related to previous radiation therapy, improper use of staplers, postoperative complications, such as anastomotic fistula and local ischemia, and inflammatory bowel disease.…”

Section: Introductionmentioning

confidence: 99%

Treatment of rectal anastomotic atresia with transurethral prostate resection instrumentation: A report of three cases

Hu,

Qin,

Wei

et al. 2024

Exp Ther Med

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Dixon surgery for rectal cancer can lead to severe intestinal narrowing and blockage that is difficult to treat with open surgery or colonoscopy. The aim of the present study was to develop a minimally invasive approach for treating rectal anastomotic atresia based on three cases that were managed with transurethral prostate resection instrumentation. Preoperative imaging determined the distance from the anastomotic closure to the anal margin, the length of the anastomotic closure and the degree of proximal intestinal dilation for all cases. During the procedure, the anastomotic site was visualized, and a circular electrode was used to excavate and open the blockage. Membrane-like closures were directly incised to achieve satisfactory results, with an anastomotic diameter >20 mm. Those cases with tubular atresia required an initial incision using the prostate resectoscope to relieve the obstruction, followed by radial incisions until achieving an anastomotic diameter >20 mm. At 3-6 months post-dilation, two of the patients with anastomotic atresia >20 mm had satisfactory bowel movements, whereas the remaining patient experienced tumor recurrence at the anastomotic site and discontinued treatment. This case series demonstrates the potential of transurethral prostate resection instrumentation as a safe and effective minimally invasive approach for rectal anastomotic atresia. Given that prostate resection instrumentation is readily available in hospitals in China, this approach is widely accessible to most patients. Furthermore, the technique leverages existing surgical technology and practices, requiring only a shift in the surgical site.

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Section: Introductionmentioning

confidence: 99%

Treatment of rectal anastomotic atresia with transurethral prostate resection instrumentation: A report of three cases

Hu,

Qin,

Wei

et al. 2024

Exp Ther Med

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Late diagnosis of congenital anal canal stenosis. Case report and literature analysis

Levin, MD, PhD, DSc,

Mendelson MD

2024

GHOA

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We describe a case of congenital stenosis in the anal canal (ACS) in an elderly woman who suffered from severe constipation since early childhood. Digital examination revealed a thin membrane in the anal canal with an opening through which only the index finger could fit. An X-ray examination revealed a narrowing in the anal canal at 1.9 cm from the normally formed anus. The Foley catheter balloon was stuck above the membrane. We found only one article describing delayed diagnosis of congenital rectal stenosis in a 17-year-old adolescent. But she also had a membrane in her anal canal. A PubMed search identified 14 articles that published radiographic studies of rectal atresia and rectal stenosis in children. In all cases radiometric analysis revealed atresia or stenosis not in the rectum, but in the anal canal. In 8 cases it was possible to determine the exact location of the membrane. It was located approximately 1 cm from the anal verge. Conclusion. An analysis of articles proved that in all cases the membrane was not in the rectum, but in the anal canal. This discovery allows the membrane to be excised through the anal approach without damaging the anal canal and the innervation of the anorectal area. It has been shown that in a significant number (≈5%) of children with functional megacolon, ACS may be the cause of the pathology. Scientifically based methods for diagnosing and treating ACA/ACS are proposed. The localization and form of the defect suggests that it occurs in the embryonic period due to a violation of the rupture of the membrane in embryos 13.5–135 cm long.

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Jejunal Atresia With a Rare Association: A Case Report and Literature Review

Qumsieh,

Qawasmeh,

Jaradat

et al. 2024

Cureus

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Jejunoileal atresia, a common cause of neonatal intestinal obstruction, typically manifests shortly after birth. This case report highlights a rare instance of a late preterm female neonate presenting with type 4 jejunoileal atresia along with proximal rectal atresia, an exceedingly uncommon combination. Initial symptoms included bilious emesis and failure to pass meconium, leading to surgical correction of jejunoileal atresia. However, postoperative complications, including vomiting and jaundice, prompted further investigation, revealing rectal atresia during a fluoroscopic study on day 29. Subsequent surgery was required to address the rectal atresia, resulting in additional challenges such as short bowel syndrome and infection. The complexity of diagnosis and management underscores the importance of thorough evaluation of the lower gastrointestinal tract in neonates with jejunoileal atresia to prevent misdiagnosis and reduce the need for multiple surgeries. Rectal atresia, which is a very rare anorectal abnormality, in combination with jejunoileal atresia is considered an incredibly unusual, exceptionally unique case; as to our knowledge, no similar presentation had previously occurred. Prompt identification and simultaneous treatment of both conditions can help mitigate complications, minimize the risk of necrosis and perforation, and improve overall outcomes. Comprehensive management strategies that encompass thorough diagnostic evaluation and coordinated surgical interventions are crucial for optimizing the care of neonates with complex intestinal malformations, ensuring timely resolution of symptoms, and reducing long-term morbidity.

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Rectal Atresia Treated Via a Transanal and Posterior Sagittal Approach: A Report of Two Cases

Cited by 3 publications

References 19 publications

Treatment of rectal anastomotic atresia with transurethral prostate resection instrumentation: A report of three cases

Treatment of rectal anastomotic atresia with transurethral prostate resection instrumentation: A report of three cases

Late diagnosis of congenital anal canal stenosis. Case report and literature analysis

Jejunal Atresia With a Rare Association: A Case Report and Literature Review

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