Congenital Pouch Colon
Congenital pouch colon
Review of articles & Case presentation
Dr. Mautaz Al Ani Pediatric surgeon
European board - pediatric surgery E.B.P S
Iraqi board - pediatric surgery F.I.B.M.S
Congenital pouch colon
Introduction
Incidence Etiology and Embryogenesis
Classification
Types Management
Complication
CASE PRESENTATION Recommendation
Introduction :
The colon is replaced by a pouch-like dilatation associated with anorectal agenesis. Communicates with the urogenital tract by a large fistula.
Incidence :
It varies in different parts of the world. Northern part of the Indian, Sporadic case China, Japan, Sweden, UK and USA
Pouch colon is more common in males
Etiology and Embryogenesis
The exact embryogenesis is not known.
Trusler obstruction
Because of chronic
Chatterjee Primary disorder of the proximal end of the hindgut .
A genetic predisposition needs to be ruled out. The high density of cases in the
northern belt of Indian points towards environmental factors with deficiency
of iodine or vitamin B.
Classification
CPC should have the following anatomical criteria: 1. Anorectal agenesis. 2. The colon is short . 3. Pouch formation for a varying length. 4. Wall is thick and muscular with hypertrophied mucosa. 5. The fistula with the genitourinary tract is large, muscular and long.
6. The pattern changes suddenly and sharply.
There is no transitional zone between the pouch colon and the normal bowel.
Types :
Management
The aim of surgery Is to utilize the available length of colon for absorption and storage capacity as well as for propelling fecal matter
onward with a continent anal opening.
Incomplete CPC, the pouch can be excised
Complete CPC , tubularizing the pouch in the form of Coloplasty.
Technical skill, the availability of facilities and post-operative care. May direct the options
COMPLICATION
1. leak following coloplasty . 2. wound dehiscence occurs in 4-5%. 3. Mortality
Review of articles & Case presentation
Dr. Mautaz Al Ani Pediatric surgeon
European board - pediatric surgery E.B.P S
Iraqi board - pediatric surgery F.I.B.M.S
Congenital pouch colon
Introduction
Incidence Etiology and Embryogenesis
Classification
Types Management
Complication
CASE PRESENTATION Recommendation
Introduction :
The colon is replaced by a pouch-like dilatation associated with anorectal agenesis. Communicates with the urogenital tract by a large fistula.
Incidence :
It varies in different parts of the world. Northern part of the Indian, Sporadic case China, Japan, Sweden, UK and USA
Pouch colon is more common in males
Etiology and Embryogenesis
The exact embryogenesis is not known.
Trusler obstruction
Because of chronic
Chatterjee Primary disorder of the proximal end of the hindgut .
A genetic predisposition needs to be ruled out. The high density of cases in the
northern belt of Indian points towards environmental factors with deficiency
of iodine or vitamin B.
Classification
CPC should have the following anatomical criteria: 1. Anorectal agenesis. 2. The colon is short . 3. Pouch formation for a varying length. 4. Wall is thick and muscular with hypertrophied mucosa. 5. The fistula with the genitourinary tract is large, muscular and long.
6. The pattern changes suddenly and sharply.
There is no transitional zone between the pouch colon and the normal bowel.
Types :
Management
The aim of surgery Is to utilize the available length of colon for absorption and storage capacity as well as for propelling fecal matter
onward with a continent anal opening.
Incomplete CPC, the pouch can be excised
Complete CPC , tubularizing the pouch in the form of Coloplasty.
Technical skill, the availability of facilities and post-operative care. May direct the options
COMPLICATION
1. leak following coloplasty . 2. wound dehiscence occurs in 4-5%. 3. Mortality