Anorectal Atresia

Definition

Definition of Anorectal Atresia
An anal atresia is a birth defect in which the rectum is malformed. There are a number of known causes, including Trisomy 22.

Symptoms

Symptoms of Anorectal Atresia

1. No anal opening present at birth
2. Anal opening in the wrong location
3. Baby does not pass the first stool within 24-48 hours after birth
4. Stool being excreted through the vagina, penis, scrotum, or urethra
5. Tight, swollen stomach
6. No bowel control by age 3

Causes

Causes of Anorectal Atresia
Consult with your doctor.

Diagnosis

Diagnosis of Anorectal Atresia
When an infant is born with an anorectal malformation, it is usually detected quickly as it is a very obvious defect. Doctors will then determine the type of birth defect the child was born with and whether or not there are any associated malformations. It is important to determine the presence of any associated defects during the newborn period in order to treat them early and avoid further sequelae. There are two main categories of anorectal malformations: those that require a protective colostomy and those that do not. The decision to open a colostomy is usually taken within the first 24 hours of birth.

Treatment

Treatment of Anorectal Atresia
Imperforate anus usually requires immediate surgery to open a passage for feces unless a fistula can be relied on until corrective surgery takes place. Depending on the severity of the imperforate, it is treated either with a perineal anoplasty or with a colostomy.

Prognosis

Prognosis of Anorectal Atresia
With a high lesion, many children have problems controlling bowel function and most also become constipated. With a low lesion, children generally have good bowel control, but they may still become constipated.

For children who have a poor outcome for continence and constipation from the initial surgery, further surgery to better establish the angle between the anus and the rectum may improve continence and, for those with a large rectum, surgery to remove that dilated segment may significantly improve the bowel control for the patient. An antegrade enema mechanism can be established by joining the appendix to the skin (Malone stoma); however, establishing more normal anatomy is the priority.

Prevention

Prevention of Anorectal Atresia
Consult with your doctor.