Congenital pouch colon with imperforate anus; a report of 3 cases

Congenital pouch colon [CPC] is an unusal condition in imperforate anus [IA] usually of high variety this malfotmation is mostly reported from India, where it comprises about 7% of all anorectal malformations. In this anomaly the normal colon is very short or absent and is replaced by a pouch like dilatation that usually communicates through a fistula with genitourinary tract or persistent cloaca. We are reporting on three cases of newborns [2 females, and 1 male] with this anomaly diagnosed during September 2001 to September 2004 These three cases comprise less than 3% of all cases of IA during this time period. The two girls had anorectal agenesia, short segment of colon and a pouch with vaginal fistula and persistent cloaca [Type II]. Colon in the third case was replaced by a dilated pouch that communicated with a wide fistula to the bladder [Type I]. This is very important for pediatric surgeons to be aware of the features of this condition to allow for proper diagnosis and surgical management

Diagnosis of coloretal polyps by hydrocolonic sonography in children with rectal bleeding

Because of the inherent danger and associated discomfort of invasive procedures such as colonoscopy or double contrast barium enema involving exposure to radiation, we studied the value of hydrocolonic sonography in the diagnosis of colorectal polyps in children with rectal bleeding. From March 2005 to January 2006, 46 children from 2.5-11 years of age presented with hematochezia were examined by means of hydrocolonic sonography and colonoscopy. On colonoscopy, 21 patients had normal results, 19 had polyps, 3 had proctitis, 2 had lymphonodular hyperplasia and 1 had anal fissure. Only 7 of 19 colorectal polyps were diagnosed by conventional abdominal sonography [37%], whereas hydrocolonic sonography permitted the diagnosis of 17 [89.5%] with a specificity equal to 92.5%. In comparison with colonoscopy, positive predictive value of hydrocolonic sonography was 89.4% and negative predictive value was 92.5%. Hydrocolonic sonography is a accurate and safe approach to evaluating children with rectal bleeding. Thus, it can be regarded as an appropriate replacement of barium enema