Congenital multiple colonic atresias in the sigmoid colon and upper rectum

Congenital colonic atresia develops in 1 in 20,000 to 66,000 births, accounting for 1.8–15% of all intestinal atresias. Approximately 8.9% of patients with colonic atresia have multiple colonic atresias. A female infant with abdominal distention and bilious vomiting did not have a bowel movement until day 3 of life. Plain radiography showed significant dilation of the intestinal tract and no gas in the pelvic cavity. A contrast enema at the age of 3 days showed microcolon and obstruction at the level of the upper rectum. Operative findings included 3 membranous atresias (Type Ⅲ). For the 2 proximal membranous atresias, membranectomy and colostomy in the sigmoid colon were performed. Preoperative contrast enema at 10 months showed a gap between the distal side of the stoma and the blind end of the rectum. The sigmoid colon and rectum were completely resected 6 cm distal to the stoma. Colostomy closure was performed. A total of 4 membranous atresias were present in the sigmoid colon and the upper rectum. In a patient with multiple atresias in the sigmoid colon and upper rectum, multiple-stage surgery could be safe after searching for complicating malformations and evaluating the intestinal tract preoperatively.