Colostomy prolapse and hernia following window colostomy in congenital pouch colon

Abstract

Congenital pouch colon, a variant of anorectal malformation, is a rare anomaly with a high incidence in North India and although the anatomy and diagnostic features have been well described, the surgical treatment continues to be challenging. This report describes the complications following a less preferred but often practised surgical option—a temporizing window colostomy in three babies. A window colostomy predisposes to prolapse of the entire pouch colon with herniation of bowel loops, intestinal obstruction and failure to thrive. Depending on the state of the child, either a proximal diverting stoma or tubularization of the pouch with a terminal stoma is recommended as the procedure of choice for the initial surgical management of this complex and rare malformation.