Saturday, May 4, 2019

Anorectal Anamoly / Anorectal Malformation / Imperforate Anus


Imperforate is commonly used term when a child is born without Anal opening at normal Anal site. This is one of the common major congenital abnormalities producing intestinal obstruction in neonate. Some of them communicate with urinary tract which needs to be tackled at the time of correction. If not diagnosed in time and managed properly, may end up with long term irreparable damage including death at times. It appears that it is difficult to miss this condition as the problem is obvious. However even today diagnosis is missed /delayed once in every 4 case which increases suffering and longterm poor control of sphincters, that can easily be avoided by simple observation.

It is very appropriate to note that lifetime misery can be avoided by the first doctor to diagnose the issue and the first Surgeon to manage the problem appropriately.

Usually there are three types in relation to sphincters: Low: can be operated from below in a single stage, Intermediate and High- Single/ multiple stages. 

Most of these cases are handled in single stage at Praanadah Speciality Hospital. On the contrary a poor assessment can result in multiple stages even in low type of Imperforate anus. Main issue is preserving sphincters which is important for continence of stools which is disturbed by inadequate assessment of the problem and multiple stages when not required.

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