Colonic and Rectal Atresias

  • Tomas WesterEmail author
Living reference work entry

Latest version View entry history



Colonic and rectal atresias are very rare. Both have been considered to be the result of insufficient blood supply during intrauterine life. Rectal atresia is included in classifications of anorectal malformations. Colonic and rectal atresia both present as neonatal bowel obstruction. The diagnosis of colonic atresia is usually suspected on plain abdominal radiographs. A contrast enema is useful to show a microcolon. Rectal atresia is suspected in neonates with bowel obstruction, where it is impossible to pass a catheter through the rectum, although the anus is normal. Colonic atresia is often operated with resection of dilated colon and primary anastomosis. In complicated cases, it is common to open a colostomy in the neonate and do the anastomosis later. There are several procedures for rectal atresias. Many investigators open a colostomy in the neonate and reconstruct the rectum through a posterior sagittal approach at a later stage. Long-term functional outcome is usually favorable in patients with colonic as well as rectal atresia.


Colonic atresia Rectal atresia Primary anastomosis Posterior sagittal approach Outcome 


  1. Akgur FM, Olguner M, Hakguder G, et al. Colonic atresia associated with Hirschsprung’s disease: it is not a diagnostic challenge. Eur J Pediatr Surg. 1998;8:378–9.CrossRefGoogle Scholar
  2. Anderson N, Malpas T, Robertson R. Prenatal diagnosis of colon atresia. Pediatr Radiol. 1993;23:63–4.CrossRefGoogle Scholar
  3. Arca MJ, Oldham KT. Atresia, stenosis, and other obstructions of the colon. In: Coran AG, Adzick NS, Krummel TM, Laberge J-M, Shamberger RC, Caldamone AA, editors. Pediatric surgery. Philadelphia: Elsevier Saunders; 2012. p. 1247–53.CrossRefGoogle Scholar
  4. Barnard CN, Louw JH. The genesis of intestinal atresia. Minn Med. 1956;39:745–8.PubMedGoogle Scholar
  5. Benawra R, Puppala BL, Mangurten HH, et al. Familial occurrence of congenital colonic atresia. J Pediatr. 1981;99:435–6.CrossRefGoogle Scholar
  6. Benson CD, Lotfi MW, Brough AJ. Congenital atresia and stenosis of the colon. J Pediatr Surg. 1968;3:253–7.CrossRefGoogle Scholar
  7. Bland Sutton JD. Imperforate ileum. Am J Med Sci. 1889;98:457.CrossRefGoogle Scholar
  8. Boles ET, Vassy LE, Ralston M. Atresia of the colon. J Pediatr Surg. 1976;11:69–75.CrossRefGoogle Scholar
  9. Coran AG, Eraklis AJ. Atresia of the colon. Surgery. 1969;65:828–31.PubMedGoogle Scholar
  10. Davenport M, Bianchi A, Doig CM, Gough DCS. Colonic atresia: current results of treatment. J R Coll Surg Edinb. 1990;35:25–8.PubMedGoogle Scholar
  11. Defore WW, Garcia-Rinaldi R, Mattox KL, Harberg FJ. Surgical management of colon atresia. Surg Gynecol Obstet. 1976;143:767–9.PubMedGoogle Scholar
  12. Dorairajan T. Anorectal atresia. In: Stephens FD, Smith ED, Paul NW, editors. Anorectal malformations in children. New York: Liss; 1988. p. 105–10.Google Scholar
  13. El-Asmar KM, Abdel-Latif M, El-Kassaby AA, Soliman MH, El-Behery MM. Colonic atresia: association with other anomalies. J Neonatal Surg. 2016;5(4):47.CrossRefGoogle Scholar
  14. Etensel B, Temir G, Karkiner A, et al. Atresia of the colon. J Pediatr Surg. 2005;40:1258–68.CrossRefGoogle Scholar
  15. Evans CW. Atresias of the gastrointestinal tract. Int Abstr Surg. 1951;92:1–8.PubMedGoogle Scholar
  16. Fairbanks TJ, Kanard RC, Del Moral PM, et al. Colonic atresia without mesenteric vascular occlusion. The role of the fibroblast growth factor 10 signalling pathway. J Pediatr Surg. 2005;40:390–6.CrossRefGoogle Scholar
  17. Freeman NV. Congenital atresia and stenosis of the colon. Br J Surg. 1966;53:595–9.CrossRefGoogle Scholar
  18. Gaub OC. Congenital stenosis and atresia of the intestinal tract above the rectum, with a report of an operated case of atresia of the sigmoid in an infant. Trans Am Surg Assoc. 1922;40:582–670.Google Scholar
  19. Gieballa M, AlKharashi N, Al-Namshan M, et al. outcomes of transanal endorectal pull-through for rectal atresia. BMJ Case Rep. 2018;bcr-2017-224080.Google Scholar
  20. Guttman FM, Braun P, Garance PH. Multiple atresias and a new syndrome of hereditary multiple atresias involving the gastrointestinal tract from the stomach to rectum. J Pediatr Surg. 1973;8:633–4.CrossRefGoogle Scholar
  21. Hamrick M, Eradi B, Bischoff A, et al. Rectal atresia and stenosis: unique anorectal malformations. J Pediatr Surg. 2012;47:1280–4.CrossRefGoogle Scholar
  22. Kim PCW, Superina RA, Ein S. Colonic atresia combined with Hirschsprung’s disease: a diagnostic and therapeutic challenge. J Pediatr Surg. 1995;30:1216–7.CrossRefGoogle Scholar
  23. Kim S, Yedlin S, Idowu O. Colonic atresia in monozygotic twins. Am J Med Genet. 2000;91:204–6.CrossRefGoogle Scholar
  24. Lauwers P, Moens E, Wustenberghs K, et al. Association of colonic atresia and Hirschsprung’s disease in the newborn: report of a new case and review of the literature. Pediatr Surg Int. 2006;22:277–81.CrossRefGoogle Scholar
  25. Louw JH. Investigations into the etiology of congenital atresia of the colon. Dis Colon Rectum. 1964;7:471–8.CrossRefGoogle Scholar
  26. Louw JH, Barnard CN. Congenital intestinal atresia: observations in its origin. Lancet. 1955;2:1065–7.CrossRefGoogle Scholar
  27. Magnus RV. Rectal atresia as distinguished from rectal agenesis. J Pediatr Surg. 1968;3:593–8.CrossRefGoogle Scholar
  28. Nguyen TL, Pham DH. Laparoscopic and transanal approach for rectal atresia: a novel alternative. J Pediatr Surg. 2007;42:E25–7.CrossRefGoogle Scholar
  29. Peck DA, Lynn HB, Harris LE. Congenital atresia and stenosis of the colon. Arch Surg. 1963;87:86–97.CrossRefGoogle Scholar
  30. Peña A. Anorectal malformations. Semin Pediatr Surg. 1995;4:35–47.PubMedGoogle Scholar
  31. Peña A. Anorectal anomalies. In: Puri P, editor. Newborn surgery. Oxford: Butterworth-Heinemann; 1996. p. 379–94.Google Scholar
  32. Philippart AI. Atresia, stenosis, and other obstructions of the colon. In: Welch KJ, Randolph JG, Ravitch MM, O’Neill JA, Rowe MI, editors. Pediatric surgery. 4th ed. Chicago/London/Boca Raton: Year Book Medical Publishers; 1986. p. 984–8.Google Scholar
  33. Potts WJ. Congenital atresia of intestine and colon. Surg Gynecol Obstet. 1947;85:14–9.PubMedGoogle Scholar
  34. Powell RW, Raffensperger JG. Congenital colonic atresia. J Pediatr Surg. 1982;17:166–70.CrossRefGoogle Scholar
  35. Puri P, Fujimoto T. New observations on the pathogenesis of multiple intestinal atresias. J Pediatr Surg. 1988;23:221–5.CrossRefGoogle Scholar
  36. Sharma S, Gupta DK. Varied facets of rectal atresia and rectal stenosis. Pediatr Surg Int. 2017;33(8):829–836.Google Scholar
  37. Upadhyaya P. Rectal atresia: transanal, end-to-end, rectorectal anastomosis: a simplified, rational approach to management. J Pediatr Surg. 1990;25:535–7.CrossRefGoogle Scholar
  38. Upadhyaya P. Rectal atresia. In: Puri P, editor. Newborn surgery. Oxford: Butterworth-Heinemann; 1996. p. 395–8.Google Scholar
  39. Watts AC, Sabharwal AJ, MacKinlay GA, et al. Congenital colonic atresia: should primary anastomosis always be the goal? Pediatr Surg Int. 2003;19:14–7.PubMedGoogle Scholar
  40. Webb CH, Wangensteen OH. Congenital intestinal atresia. Am J Dis Child. 1931;41:262–84.Google Scholar
  41. Zia-ul-Miraj Ahmed M, Brereton RJ, Huskinsson L. Rectal atresia and stenosis. J Pediatr Surg. 1995;30:1546–50.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Pediatric SurgeryKarolinska University Hospital, Karolinska InstitutetStockholmSweden

Personalised recommendations