Authors : Vaibhav Pandey, Pranay Panigrahi, Rakesh Kumar
Congenital Pouch colon without fistula: Our experiences and lessons learned
Introduction: In anorectal malformations (ARM), usually the bowel ends as fistula into the uro-genital tract. ARM without fistula implies that the rectum ends blindly at the level of the bulbar urethra without a fistula. Pouch colon is another rare variant associated with ARM. The combination of these two rare variants is still rarer with unique variations.
Material and method: The retrospective study was conducted after approval by institutional ethical committee and case records of patients with pouch colon without fistula were assessed for gender, associated anomalies, Intra-operative complications and continence outcome. Data were coded and summarized using Statistical Package for Social Sciences (SPSS) version 16.0 for windows.
Results: Four cases with pouch colon without fistula presented during the study period. All patients were male. Mean age of presentation was 2.34 ±0.45 days. One patient was having Down’s syndrome and 50% (2 cases) had cardiac lesion. 50% (2 cases) had pneumoperitoneum at time of presentation and presented on 3rd day of life. Invertogram showed high type of Anorectal malformation. These were managed with three staged repair. 50% (2 cases) were managed with primary Abdominoperineal pull through. 75% had Type 2 pouch and 25% had type 1 pouch colon [Figure 1-2]. All patients underwent regular dilatation. At age of three years 75 % had good continence according to Kelly’s score and 25% had fair continence.
Conclusion: This extremely rare entity is associated with higher incidence of congenital anomalies and pneumoperitoneum with overall good prognosis.
Keywords: Anorectal malformation, Pouch colon, ARM without fistula, APPT.