CONGENITAL SHORT COLON

Congenital short colon (CSC) is a condition in which the colon is repl aced, wholly or partially, by a dilated pouch together with anorectal malformation and a colourinary fistula. Most of the reported series ha ve been from northern India where this malformation is frequent. This paper details the management of 108 patients with CSC over a period of 23 years, The patients were classified into two types: (1) Partial sh ort colon, where a segment of normal colon is present between the ileu m and the sac. These patients could be treated by excision of the pouc h and pull-through of the segment of normal colon during either single - or two-stage surgery. (2) Complete short colon, where the ileum open ed directly into the sac, and formation of a tube from this sac (colop lasty) was required in one or more stages to provide a length of norma lly functioning colon. Review of the results showed staged management to be superior. The follow-up has ranged between 3 and 7 years, with s atisfactory long-term results in both groups of patients. We have evol ved a protocol for the management of CSC that has improved the prognos is and quality of life of these patients.