Mathur and Saxena developed a classification for congenital pouch colon (CPC) which can help guide the surgical management. The authors are from RNT Medical College (Udaipur, Inda) and the Medical University of Graz.
Congenital pouch colon is a rare form of anorectal malformation.
General features:
(1) a colonic pouch replaces all or some of the normal colon
(2) the pouch empties through a fistula into the genitourinary tract
Parameters:
(1) normal colon
(2) pouch colon
Normal Colon
Sections Replaced by Pouch Colon
Type
none
entire colon
Type 1
cecum
part of ascending, transverse, descending and rectosigmoid
Type 2
cecum, ascending and transverse colon
descending and rectosigmoid
Type 3
cecum, ascending, transverse, descending colon
rectosigmoid
Type 4
"transverse"
right and left segments
Type 5
All types undergo fistula ligation. Additional management depends on the type.
Type
Surgery
Types 1 or 2, healthy pouch
ileostomy with pouch left in situ (with subsequent coloplasty, pull through and stoma closure)
Types 1 or 2, ischemia or perforation
excise pouch with either ileostomy (with subsequent ileoanal pull through and stoma closure) or one stage pull through
Types 3 or 4
excise pouch with end colostomy (with subsequent pull through and stoma closure)
Type 5
excise distal pouch, coloplasty (proximal pouch) and ileostomy (with subsequent pull through and stoma closure)
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