Surgical management of congenital pouch colon in Lebanon: A case report and review of the literature

Abstract

Congenital pouch colon (CPC) is a rare congenital abnormality, in which a pouch-like dilatation partially or completely replaces the colon, creating a fistula with the urogenital. Congenital colonic pouch is an extremely rare congenital disease mainly reported in India, and to date there are no reported cases in Lebanon. In this paper, we present a case of full-term male neonate diagnosed with a congenital colon pouch in Lebanon. A full-term neonate presented with imperforate anus, abdominal distention, and vomiting. Diagnostic assessments revealed a well-encapsulated mass compressing the intestines and ureter. Surgical intervention identified a type I CPC with a meconium-filled pouch directly connected to the small intestine, and an absent ileocecal valve, prompting an ileostomy. Following the surgery, no postoperative complications were noted. Early imaging can help address the diagnosis to start the appropriate management, plan for surgery to prevent the development of a megacolon and therefore, perforation. The objective is to be aware and consider congenital colonic pouch diagnosis after encountering newborns with such clinical presentation in order to direct clinical investigations toward the diagnosis and treatment of the case early, thus reducing the risk of complications and improving the patient's quality of life.

Keywords: Anorectal malformations; Case report; Colonic pouch; Congenital anomaly; Congenital pouch colon.

Fig. 1

MRI anterior view showing a well encapsulated mass containing large amount of gas, compressing and displacing the small intestines forward.

Fig. 2

MRI lateral view showing a well encapsulated mass containing large amount of gas, compressing and displacing the small intestines forward.

Fig. 3

X-ray showing a dilated and pouch-like structure.

Fig. 4

Surgical management of the congenital colonic pouch.