eMedicine Specialties > Pediatrics: Surgery > General Surgery

Atresia, Stenosis, and Other Obstruction of the Colon: Workup

Author: Nelson G Rosen, MD, FACS, FAAP, Assistant Professor of Surgery and Pediatrics, Albert Einstein College of Medicine; Attending Pediatric Surgeon and Director, Pediatric Trauma Center, Department of Pediatric General Surgery, Schneider Children's Hospital
Coauthor(s): Jeffrey Zitsman, MD, Director, Minimal Access Surgery, Associate Clinical Professor, Department of Surgery, Division of Pediatric Surgery, Children's Hospital of New York, New York Presbyterian Medical Center; Jeremy T Aidlen, MD, Fellow in Pediatric Surgery, North Shore-Long Island Jewish Health System, Schneider's Children's Hospital
Contributor Information and Disclosures

Updated: Apr 28, 2008

Workup

Laboratory Studies

In all children with neonatal bowel obstruction should, obtain electrolyte measurement and CBC count and perform a crossmatch prior to operative intervention.

Imaging Studies

  • Antenatal ultrasonography may reveal bowel loop distention or polyhydramnios.
  • Plain radiography of the abdomen reveals bowel obstruction and may reveal a prominent dilated loop. A prone view shows absence of gas in the rectum, although gas may be present if the film was obtained after the rectum was examined.
  • Contrast enema may be performed prior to surgery at the discretion of the surgeon and can be useful in ruling out the presence of other lesions downstream from the atresia. It reveals a microcolon with a rounded proximal end (see Media file 2).
  • Radiography in congenital colonic stenosis also reveals an obstructive pattern that may mimic atresia. Contrast enema reveals narrowing of the colon, with limited filling of the dilated proximal colon (see Media file 3).

Diagnostic Procedures

  • Rectal biopsy (performed either as a suction biopsy prior to surgical correction or at the time of operative correction) should be considered important in evaluating for associated Hirschsprung disease.42,29

More on Atresia, Stenosis, and Other Obstruction of the Colon

Overview: Atresia, Stenosis, and Other Obstruction of the Colon
Workup: Atresia, Stenosis, and Other Obstruction of the Colon
Treatment: Atresia, Stenosis, and Other Obstruction of the Colon
Follow-up: Atresia, Stenosis, and Other Obstruction of the Colon
Multimedia: Atresia, Stenosis, and Other Obstruction of the Colon
References
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References

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Further Reading

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Keywords

colonic atresia, colonic stenosis, colonic stricture, colonic obstruction, congenital colon obstruction, colonic narrowing, abdominal distention, failure to pass meconium, narrowed colon, Hirschsprung disease, small left colon syndrome, obturation obstruction, meconium ileus, meconium plug, abdominal distention, failure to pass meconium, congenital stenosis, acquired stenosis, stricture, necrotizing enterocolitis, intestinal blockage, bowel obstruction, feeding intolerance
 
failure to thrive, colon atresia, small intestinal atresia, dilated bowel loops, polyhydramnios, abdominal wall defects, genitourinary tract abnormalities, anal atresia, imperforate anus, colonic perforation, omphalocele, aganglionosis, mesenteric vascular incident, cryptophthalmia syndrome, cleft lip and palate, dysplastic kidneys, proximal jejunal atresia, arthrogryposis, proximal intestinal atresia, neoplasm, malrotation, Riley-Day syndrome, spontaneous colon ischemia, coloboma, cataracts, facial hemihypertrophy

facial asymmetry, exophthalmia, bilateral optic nerve hypoplasia, vascular interruption, thrombosis, volvulus, herniation, bowel necrosis, duodenal atresia, bowel ischemic injury, internal hernia, choledochal cyst, volvulus, bowel infarction, Crohn disease, tuberculosis

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Contributor Information and Disclosures

Author

Nelson G Rosen, MD, FACS, FAAP, Assistant Professor of Surgery and Pediatrics, Albert Einstein College of Medicine; Attending Pediatric Surgeon and Director, Pediatric Trauma Center, Department of Pediatric General Surgery, Schneider Children's Hospital
Nelson G Rosen, MD, FACS, FAAP is a member of the following medical societies: American Academy of Pediatrics, American College of Surgeons, American Pediatric Surgical Association, American Trauma Society, Association of Military Surgeons of the US, Canadian Association of Pediatric Surgeons, and Eastern Association for the Surgery of Trauma
Disclosure: Nothing to disclose.

Coauthor(s)

Jeffrey Zitsman, MD, Director, Minimal Access Surgery, Associate Clinical Professor, Department of Surgery, Division of Pediatric Surgery, Children's Hospital of New York, New York Presbyterian Medical Center
Jeffrey Zitsman, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Surgeons, American Pediatric Surgical Association, and International Pediatric Endosurgery Group
Disclosure: Nothing to disclose.

Jeremy T Aidlen, MD, Fellow in Pediatric Surgery, North Shore-Long Island Jewish Health System, Schneider's Children's Hospital
Jeremy T Aidlen, MD is a member of the following medical societies: American College of Surgeons
Disclosure: Nothing to disclose.

Medical Editor

Kurt D Newman, MD, Vice Chairman, Department of Pediatric Surgery, Children's National Medical Center; Professor, Departments of Surgery and Pediatrics, George Washington University School of Medicine
Kurt D Newman, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Surgeons, American Pediatric Surgical Association, and Society of Surgical Oncology
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine.com, Inc
Disclosure: Pfizer Inc Stock Investment from broker recommendation; Avanir Pharma Stock Investment from broker recommendation

Managing Editor

Deborah F Billmire, MD, Associate Professor, Department of Surgery, Indiana University Medical Center
Deborah F Billmire, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American College of Surgeons, American Pediatric Surgical Association, Phi Beta Kappa, and Society of Critical Care Medicine
Disclosure: Nothing to disclose.

CME Editor

H Biemann Othersen Jr, MD, Professor of Surgery and Pediatrics, Emeritus Head, Division of Pediatric Surgery, Medical University of South Carolina
H Biemann Othersen Jr, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American Association for the Surgery of Trauma, American Burn Association, American Cancer Society, American College of Surgeons, American Medical Association, American Pediatric Surgical Association, American Society for Parenteral and Enteral Nutrition, American Surgical Association, American Thoracic Society, British Association of Paediatric Surgeons, Society for Surgery of the Alimentary Tract, Society of Critical Care Medicine, South Carolina Medical Association, Southeastern Surgical Congress, Southern Medical Association, Southern Society for Pediatric Research, and Southern Thoracic Surgical Association
Disclosure: Nothing to disclose.

Chief Editor

Marleta Reynolds, MD, Professor of Surgery, Feinberg School of Medicine, Northwestern University; Interim Head, Division of Pediatric Surgery, Department of Surgery, Children's Memorial Hospital of Chicago
Marleta Reynolds, MD is a member of the following medical societies: American Pediatric Surgical Association
Disclosure: Nothing to disclose.

 
 
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