Congenital Pouch Colon, A Rare Anomaly

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Congenital pouch colon
Sigmoid colon forming a pouch. Source: BMC

Congenital Pouch Colon (CPC) is a highly rare anorectal anomaly. So rare that many doctors don’t even know about it. Thus, they find themselves up a gum tree if they ever take turns with it. But should you worry? No, because by the end of this read, you’d be everything but a stranger to CPC.

A newborn male, 3 days old, born through a normal vaginal delivery, rolled in to the hospital. His mother complained of failure to pass stools and a visible abdominal distension in her son. However, she did not report any meconuria i-e greenish stools in the urine.

Examinations For An Unusual Colon

Upon examination, the baby’s weight came out be 2.5 kg. He displayed a visible abdominal distension with signs of lethargy and dehydration. But the most unusual finding, the baby did not have an anal opening.

Doctors inserted a nasogastric tube to look for any tracheoesophageal fistula. Luckily, they did not observe such a thing. However, the did see a rare anorectal anomaly on an invertogram. Also on an abdominal radiograph, they noticed a bowel loop dilated with air/fluid to cover about half of the transverse diameter of the baby’s abdomen.

Invertogram of the patient. Source: BMC

Diagnosis: Congenital Pouch Colon

The anorectal malformation led to a diagnosis of congenital pouch colon. The doctors prepared the baby for an exploratory laparotomy. And to their expectations, they found a massively dilated sigmoid colon forming a pouch (type 4 Congenital Pouch Colon or CPC). As a treatment, they made a stoma i-e they created an opening in the bowel and connected it to a bag placed outside the body. It worked just fine on the first post-operative day. However, the child broke down on the second day. They say it was due to sepsis. Poor soul!

Source: BMC

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