Double Pouch Colon
A 2-day-old, 2.7-kilogram male full-term neonate, born out of a non-consanguineous marriage was referred to us with a complaint of absent anal opening since birth and abdominal distension and meconuria since day 1. On examination, the patient had a distended abdomen and absent anal opening with a flat perineum. The fantogram showed two large air-fluid levels in the abdomen (Fig. 1). Echocardiogram was suggestive of patent ductus arteriosus with severe pulmonary artery hypertension. At laparotomy Saxena–Mathur classification, a type V pouch colon was seen with the intervening segment of only 2 centimeters. This dumb-bell-shaped pouch colon was ischemic, thinned out at places, and had blood supply only from marginal branches (Fig. 2). The poucho-vesical fistula was divided and closed, pouch excised, and terminal ileostomy was done (Fig. 3). The patient was discharged uneventfully on 8th postoperative day. We had planned a second-stage surgery after 3 months. However, the patient, unfortunately, succumbed to lower respiratory tract infection at 2 months of age.