Brief Case Description – Type 4 Pouch Colon with Bladder Fistula A 5-day-old term neonate, born by Caesarean section, presented with complete failure to pass stool since birth and progressive abdominal distension. Clinical and radiological evaluation was suggestive of a high anorectal malformation with Pouch Colon and a bladder fistula.

After initial resuscitation, nasogastric decompression, investigations, and multidisciplinary counseling, the baby underwent exploratory laparotomy.

Intraoperatively, a Type 4 pouch colon with bladder fistula was identified. The pouch was excised, the fistula was ligated, and an end descending colostomy was fashioned. The postoperative course was closely monitored in the NICU. The baby remained hemodynamically stable, with a healthy stoma and satisfactory recovery. Key message: Early recognition, appropriate stabilization, detailed anatomical assessment, and timely surgical intervention are essential for achieving good outcomes in rare and complex anorectal malformations.

Team work makes the dream work 😊