Study of congenital pouch colon anomaly in Ahmedabad region

Background: Congenital pouch colon is an unusual abnormality of like dilation of shortened colon, associated with Ano-rectal malformation. The clinical and radiological details of this condition have been described in detail and are well established, but there is a lack of consensus regarding management protocol.
Objective: To study the epidemiology of pouch colon anomaly, analyze various modes of presentation. To see various anomalies associated and to evaluate the outcome of various surgical modalities.
Methods: A prospective study of patients of pouch colon anomaly, who were admitted in our Hospital from April 2004 to February 2007, was done. Cases ware studied as per a fixed pro-forma.
Observation and Discussion: 11.4% of all male (149) and 8.5% of all female (130) Ano-rectal malformation patients had pouch colon anomaly. They were investigated by X-ray abdomen, USG abdomen, x-ray spine and 2-D echo. Associated anomalies with pouch colon are observed, patients were managed surgically by 3 stage procedure and outcome recorded.
Conclusion: All patients except one were full term delivered. Antenatal ultrasonography could not suggest any prominent shadow in lower abdomen of fetus along with normal small bowel shadow may be antenataly diagnostic of pouch colon in a fetus. Pouch colon anomaly made 10% of total Ano-rectal malformation cases (279) and 13.46% of total high Ano-rectal malformation cases (205) who were admitted in our hospital during same study duration. The preferred surgical treatment in our study was Colorrhaphy and abdominperineal pull through with proximal loop ileostomy.