Mar 7, 2008

Anorectal Malformation or Imperforate anus

Anorectal malformation is a birth defect in which the anus and rectum do not developed properly. Anus is opening through which stool is passed and the rectum is the lowest part of large intestine just above the anus. When the child is born, he/she will have one of the following abnormalities

1. No anal opening

2. A membrane may be present over the anal opening

3. Misplaced anal opening

4. Anal opening near to the vaginal opening in female child

5. Stool is passed through by way of vagina, base of the penis or scrotum or urethra

6. Abdominal distension with no passage of stool in 24 to 48 hours after birth.

Commonly it is diagnosed at birth, when your doctor examines the baby or if the baby fails to pass stool in 48 hours or passes but through abnormal opening. There is no need to become scared, this is correctable deformity. If you are in the hospital, your doctor will immediately consult to the pediatric surgeon. If by any chance (in case of home delivery or delivery in remote areas), you need to consult nearest pediatric surgeon immediately. Like majority of birth defects, there is no particular cause for this defect also.It occurs in about 1 out of 5000 newborns. Boys are at a slightly higher risk than girls.

Along with the physical examination to check the patency of anus and other anomalies, some tests are performed to further evaluate problem:

1. Abdominal X-ray

2. Ultrasonography of abdomen

3. Echocardiography to rule out heart problem

As soon as the problem is detected, the child undergoes some necessary tests.Surgical reconstruction of the anus is the aim of treatment. In low variety, it can be done immediately without the need of colostomy. But in other severe variety initially temporary colostomy is needed before definitive operation.