UMEM Educational Pearls

Category: Visual Diagnosis

Title: What's the Diagnosis? Case by Dr. Swati Singh

Posted: 7/27/2014 by Haney Mallemat, MD (Emailed: 7/28/2014) (Updated: 7/28/2014)
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Question

2-day old baby boy presents with forceful vomiting of entire feeds, bloated belly, and has not passed stools since birth. What's the diagnosis?

Answer

Colonic atresia

Colonic Atresia

  • Condition in which a part of the colon has not formed correctly; colon is completely blocked or missing altogether. The colon is the rarest site of atresia in the GI tract.
  • Diagnosis may be suggested in prenatal sonograms and is usually revealed in affected newborns shortly after birth.
  • Patients usually present with vomiting, abdominal distention, and failure to pass meconium.
  • Differential includes:
    • Small bowel atresia

    • Meconium plug syndrome

    • Hirschsprung's disease 

  • Treatment is supportive and ultimately surgical correction

References

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http://emedicine.medscape.com/article/934014-overview