Official websites use. Share sensitive information only on official, secure websites. Correspondence to Professor Allen G Ross, a. Anorectal malformations consist of a wide spectrum of conditions which can affect both sexes and involve the distal anus and rectum as well as the urinary and genital tracts.
Patients have the best chance of a good functional outcome if the condition is diagnosed early and efficient anatomic repair is promptly instituted. This report describes a rare case of imperforate anus associated with both rectovaginal and rectocutaneous fistulas in a 6-year-old Filipino girl. The case highlights shortcomings in the healthcare delivery system combined with socio-economic factors that contributed to the delay in both diagnosis and the institution of adequate treatment. Care and preventive measures that can be implemented in low-resource settings to reduce the impact of birth defects are also discussed.
A birth defect is defined as any abnormality affecting body structure or function that is present from birth. Congenital malformations of single systems, organs or limbs comprise the majority of birth defects with a prevalence of This was followed by Hirschsprung disease, congenital atresia, and stenosis of anus without fistula.
Anorectal malformations ARM include a wide spectrum of defects in the development of the lowest portion of the intestinal and urogenital tracts. Children with these malformations have no opening where the anus should be and are said to have an imperforate anus. Imperforate anus is an embryonic birth defect that results from incomplete formation of the hindgut, resulting in the absence or abnormal localisation of the anus around the eighth week of development.
The rectum may end in a blind pouch or have openings to the urethra, bladder or vagina. Imperforate anus occurs in about 1 in live births; its aetiology remains unknown and is likely multifactorial. Imperforate anus can be categorised based on sex specific classifications and the site of the associated fistula. In females, imperforate anus may be associated with fistulas to the perineum or vaginal vestibule and rarely to the vagina. Isolated imperforate anus can also occur in both sexes, while cloaca is a rare variant seen in females where the rectum, vagina and urethra open together in a common channel.
