Colonic atresia

Colonic atresia is a rare congenital malformation characterized by a complete obstruction (atresia) of the colon, meaning that a segment of the large intestine fails to develop a continuous lumen during fetal development. It is one of the least common forms of intestinal atresia, accounting for approximately 5-15% of all intestinal atresias. The condition primarily affects the gastrointestinal system and presents in the neonatal period with signs of distal intestinal obstruction, including abdominal distension, failure to pass meconium, and bilious vomiting. The atresia most commonly involves the ascending colon or the area near the splenic flexure, and may present as a membrane, a fibrous cord, or a complete gap between the proximal and distal segments of the colon. The exact cause of colonic atresia is believed to be a vascular accident occurring during fetal development, leading to ischemic necrosis and resorption of the affected bowel segment. Most cases are sporadic, though rare familial occurrences and associations with other congenital anomalies (such as gastroschisis, Hirschsprung disease, or musculoskeletal abnormalities) have been reported. Diagnosis is typically made shortly after birth through clinical evaluation, abdominal radiographs showing dilated proximal bowel loops with absence of distal gas, and contrast enema studies revealing a microcolon (unused distal colon). Treatment for colonic atresia is surgical and is required urgently in the neonatal period. The surgical approach typically involves resection of the atretic segment with primary anastomosis or, in some cases, creation of a temporary colostomy followed by later reanastomosis. Prognosis is generally favorable when the condition is identified and treated promptly, with most infants achieving normal bowel function after surgical repair. However, outcomes may be influenced by the presence of associated anomalies, prematurity, or complications such as short bowel syndrome in cases with extensive bowel involvement.

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