Congenital pouch colon from Al Ahsa region of Saudi Arabia - A changing demography?

ABSTRACT

To study the demography, anatomy and management of congenital pouch colon [CPC] in the Al -Ahsa region of the Kingdom of Saudi Arabia [KSA]. Retrospective descriptive analysis of CPCs was made with regard to patient demography, pre- and intra-operative diagnostic features and initial neonatal management. Maternity and Children Hospital, Al-Ahsa region, KSA. Records of all children with anorectal malformations [ARM] treated between August 2004 and August 2007 were reviewed. Out of the 37cases of ARMs, seven were diagnosed as CPCs. Records were analysed for perineal findings, X-ray abdomen and invertogram [when indicated], abdominal ultrasound, type of pouch, division of any urinary fistula, and surgical management. Six out of seven CPCs were among Saudi nationals belonging to Al-Ahsa region. The male to female ratio was 43. Six were type IV and one was type III pouch. Preoperative diagnoses were made in two cases by radiology and all cases showed classic anatomical features of CPC intra-operatively. 71% had associated anomalies. Excision of pouch and end colostomy was done in three, loop stoma was done in two and excision of pouch with neonatal pull-through was done in two cases. CPCs are recently being increasingly reported in Saudi nationals. Adequate awareness about radiological, anatomical and histological features would lead to correct diagnosis and reporting. Appropriate neonatal management would prevent pouch related morbidity. Collective data from multiple centers across the Arab peninsula will help define the demographic pattern of this entity in the region