A female neonate with absent anal opening and dug perineum: Think high
Keywords:Neonate, Intestinal atresia, Perineum, Malrotation
Background: A female neonate with anorectal malformation (ARM) may have one, two, or three openings in the perineum. One opening represents cloaca while three openings usually suggest low ARM. Females with two openings in the perineum may be ARM without any fistula, rectovaginal fistula, or absent vagina. The association of ARM with multiple intestinal atresias and malrotation is rare.
Case Presentation: We present here a case of a female neonate with two perineal openings, whose perineum was explored by a general surgeon without any radiological investigation and was later found to have a high ARM, multiple jejunal and ileal atresia with malrotation.
Conclusion: ARM associated with small bowel atresia and malrotation are rarely described. Such cases require management in Pediatric surgery settings.
Levitt MA, Peña A. Outcomes from the correction of anorectal malformations. Curr Opin Pediatr. 2005; 17:394–401.
Adams SD, Stanton MP. Malrotation and intestinal atresias. Early Hum Dev. 2014; 90:921–5.
Asabe K, Handa N. Anorectal malformation with ileal atresia. Pediatr Surg Int. 1997; 12:302
Asabe K, Nagasaki A. Double atresia of the hindgut with ileal stenosis: A case report. Asian J Surg. 2004; 27:49–51.
Morikawa N, Kuroda T, Honna T, Kitano Y, Tanaka H, Takayasu H, et al. A novel association of duodenal atresia, malrotation, segmental dilatation of the colon, and anorectal malformation. Pediatr Surg Int. 2009; 25:1003.
Powell DM, Othersen HB, Smith CD. Malrotation of the Intestines in children: the effect of age on presentation and therapy. J Pediatr Surg. 1989; 24:777-780
Stoll C, Alembik Y, Dott B, Roth MP. Associated malformations in patients with anorectal anomalies. Eur J Med Genet. 2007; 50:281–90.
Maitra S, Sarkar R. Anorectal Malformation associated with small and large bowel atresias: a rare association. J Neonatal Surg. 2012; 1: 59.
Puri A, Shah S. Diagnostic clues to avoid pitfalls in the management of rare association of anorectal malformation with ileal atresia. World J Pediatr. 2016; 12:504-5.
Sinha SK, Kanojia RP, Wakhlu A, Rawat JD, Kureel SN, Tandon RK. Delayed presentation of anorectal malformations. J Indian Assoc Pediatr Surg. 2008; 13:64.
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