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Case Reports in Pediatrics
Volume 2016 (2016), Article ID 9685307, 3 pages
http://dx.doi.org/10.1155/2016/9685307
Case Report

Huge Congenital Segmental Dilatation of the Sigmoid Colon in a Neonate: A “Rarity to Meet” and a “Challenge to Treat”

1Department of Pediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria
2Division of Pediatric Radiology, Medical University Graz, Auenbruggerplatz 34, 8036 Graz, Austria
3Institute of Pathology, Medical University of Graz, Auenbruggerplatz 25, 8036 Graz, Austria

Received 29 February 2016; Revised 4 April 2016; Accepted 10 April 2016

Academic Editor: Carmelo Romeo

Copyright © 2016 Margarita Kaiser et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Only ten cases of neonatal congenital segmental dilatation (CSD) of the colon have been described so far. We present a full-term female newborn with trisomy 21, ventricular septal defect, and gross abdominal distension. Plain abdominal radiographs revealed a huge cystic lesion occupying the left hemiabdomen. Upon laparotomy on day 4 a CSD of the distal sigmoid and proximal rectum was confirmed and resected. The proximal colon was exteriorized and the distal part closed as a Hartmann pouch. Histology confirmed a huge segmental dilatation of the sigmoid without dysganglionosis or pseudodiverticula, but normal intestinal architecture. After correction of the ventricular septal defect a low rectal end-to-end anastomosis could be performed at an age of 5 months. The postoperative course was uneventful. CSD of the sigmoid colon is extremely “rare to meet” and a “challenge to treat” in the newborn period, but clinical awareness of this entity prompts pediatric surgical success.