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Imperforate anus

An imperforate anus or anal atresia is a birth defect in which the rectum is malformed. Its cause is unknown. more...

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Features

There are several forms of imperforate anus:

A low lesion, in which the colon remains close to the skin. In this case, there may be a stenosis (narrowing) of the anus, or the anus may be missing altogether, with the rectum ending in a blind pouch.
A high lesion, in which the colon is higher up in the pelvis and there is a fistula connecting the rectum and the bladder, urethra or the vagina.
A cloaca (named after the analogous orifice in amphibians), where the rectum, vagina and colon are joined into a single opening.

Imperforate anus usually presents along with other birth defects—spinal problems, anal atresia, heart problems, tracheoesophageal fistula, esophageal atresia, renal anomalies, and limb anomalies.

Treatment

Imperforate anus usually requires immediate surgery to open a passage for faeces. Depending on the severity of the imperforate, it is either treated with a perineal anoplasty or colostomy.

Prognosis

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.

Epidemiology

Imperforate anus has an estimated incidence of 1 in 5,000 live births. It is more common in boys than in girls.

Read more at Wikipedia.org

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Pediatric Surgery
From Nurse Practitioner, 4/1/01 by Risser, Nancy

* Pediatric Surgery

Adzick NS, Nance ML Pediatric surgery First of two parts. N Engl J Med 2000,342(22).-1651-57 Adzick NS, Nance ML Pediatric surgery. Second of two parts. N Engl J Med 2000; 342(23):1726-31.

The history of pediatric surgery as a well-established specialty with subspecialties is discussed in these two articles. The articles also discuss several areas of pediatric surgery that have progressed substantially in the last decade. The first article reviews surgical treatment for neonatal disorders (for example, congenital diaphragmatic hernia, esophageal atresia, Hirschsprung's disease, necrotizing enterocolitis, imperforate anus, and congenital hyperinsulinism) and new routine minimally invasive surgical techniques such as the use of highresolution cameras and telescopes, laparoscopy, and thoracoscopy. The second article focuses on organ transplantation, multidisciplinary treatments for children with cancer, surgical approaches for the prevention and treatment of childhood injuries, and fetal surgery.

Ultrasonography, color Doppler ultrasonography, and fetal magnetic resonance imaging have enhanced the accuracy of prenatal evaluation and allowed pediatric surgeons to diagnose and treat certain conditions before birth.

Nancy Risser, MN, RKC, ANP

Mary Murphy, CPNP, PhD

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