Colonic Atresia

  • Etiology: in-utero vascular accident
  • AXR: dilated colon proximal to atresia that is out of proportion to other bowel
  • Enema: microcolon that is shortened in length and is without filling defects, terminal ileum cannot be refluxed, distended air-filled loops of distal ileum
  • Clinical: can be associated with other atresias, has risk of perforation

Radiology Cases of Colonic Atresia

Enema of colonic atresia
The AXR (left) shows a distal bowel obstruction. The enema (right) shows a microcolon with opacification of only the descending colon.
Enema of colonic atresia
AXR (left) shows multiple dilated loops of bowel with an extremely dilated loop of bowel in the lower abdomen. AP (above right) and lateral (below right) images from an enema show a microcolon with contrast reaching the level of the cecum but not refluxing the terminal ileum, despite multiple attempts.

Surgery Cases of Colonic Atresia

Surgical image of colonic atresia
Surgical images show numerous loops of small bowel which are dilated, thickened and inflamed along with an extremely dilated ascending colon which is at the lower part of the left image and to the left side of the right image. An area of atresia was identified at approximately the hepatic flexure. The downstream colon (not shown) had the appearance of a microcolon. On the right image, the forceps are on the dilated appendix.
Surgical image of gastroschisis
Surgical image shows an anterior abdominal wall defect with the small bowel protruding out of the abdomen, with no surrounding membranous sac. The small bowel loops are dilated. There was an atresia just distal to the cecum and the distal colon was small in caliber. A silo for the abdominal contents was constructed. A gastrostomy and cecostomy were also placed.