TITLE:
“Inverse Type” Apple-Peel Syndrome Is Associated with Type III Colonic Atresia in a Neonate with Gastroschisis—A “New” Subtype of Colonic Atresia
AUTHORS:
Ralf-Bodo Tröbs, Micha Bahr, Ralf Schulze, Matthias Neid, Wolfgang Pielemeier, Claudia Roll
KEYWORDS:
Apple-Peel Syndrome, Colonic Atresia, Volvulus, Gastroschisis
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.5 No.4,
December
30,
2015
ABSTRACT: The colon is an unusual site of intestinal atresia. Colonic atresia is
subdivided into three phenotypes. Type III is the most common phenotype, where
the proximal and distal blind sacs are not connected. Here, we report on the
presence of colonic atresia with an “inverse apple-peel” appearance in a
neonate with gastroschisis. The lack of mesenteric fixation of the entire small
intestine, including the proximal colon, and the twisting around the vascular
axis of the superior mesenteric artery led to intrauterine volvulus and
hemorrhagic infarction of the ileocolic bowel at 34 weeks of gestation.
According to the current nomenclature for small bowel atresia, we introduce
type IIIB into the current colonic atresia classification. The occurrence of
type IIIB has been mentioned in the literature, but no single cases have been
reported until now. Patients with this type of atresia are predisposed to the
loss of the ileocecal region.