Advertisement

Anorectal Malformations

  • Andrea Bischoff
  • Belinda Hsi Dickie
  • Marc A. Levitt
  • Alberto PeñaEmail author
Living reference work entry

Later version available View entry history

First Online:
  • 248 Downloads

Abstract

This is a brief presentation of the most common types of anorectal malformations. It was written for the practicing pediatrician. It meant to be a practical guide to identify and manage these pediatric problems from the newborn until adult life. It emphasizes the importance of suspecting the associated defects, as well as to try to avoid the most common errors observed in the management of these malformations. It also includes information that will allow the clinician to establish the functional prognosis for each specific types of defect.

The management of the sequelae is considered an important part of this chapter.

Keywords

Anorectal malformation Imperforate anus Cloaca 
This is a preview of subscription content, log in to check access.

References

  1. Albanese C, Jennings R, Lopoo J, et al. One-stage correction of high imperforate anus in the male neonate. J Pediatr Surg. 1999;34:834–6.CrossRefPubMedGoogle Scholar
  2. Bianchi D, Crombleholme T, D’Alton M. Cloacal exstrophy. New York: McGraw-Hill; 2013.Google Scholar
  3. Bischoff A, Tovilla M. Advances in pediatric colorectal surgery: a practical approach to the management of pediatric fecal incontinence. Sem Pediatr Surg. In press.Google Scholar
  4. Bischoff A, Levitt MA, Peña A. Bowel management for the treatment of pediatric fecal incontinence. Pediatr Surg Int. 2009;25(12):1027–42.CrossRefPubMedPubMedCentralGoogle Scholar
  5. Bischoff A, Levitt MA, Breech L, Louden E, Peña A. Hydrocolpos in cloacal. Malformations. J Pediatr Surg. 2010;45(6):1241–5.CrossRefPubMedGoogle Scholar
  6. Bischoff A, Levitt MA, Peña A. Laparoscopy and its use in the repair of anorectal malformations. J Pediatr Surg. 2011;46(8):1609–17.CrossRefPubMedGoogle Scholar
  7. Bischoff A, Peña A, Levitt MA. Laparoscopic-assisted PSARP – the advantages of combining both techniques for the treatment of anorectal malformations with recto-bladderneck or high prostatic fistulas. J Pediatr Surg. 2013a;48:367–71.CrossRefPubMedGoogle Scholar
  8. Bischoff A, Levitt MA, Breech L, Hall J, Peña A. Vaginal switch – a useful technical alternative to vaginal replacement for select cases of cloaca and urogenital sinus. J Pediatr Surg. 2013b;48:363–6.CrossRefPubMedGoogle Scholar
  9. Brenner E. Congenital defects of the anus and rectum. Surg Gynecol Obstet. 1975;20:579–98.Google Scholar
  10. Casaccia G, Catalano OA, Bagolan P. Congenital gastrointestinal anomalies in anorectal malformations: what relationship and management? Congenit Anom (Kyoto). 2009;49(2):93–6.CrossRefGoogle Scholar
  11. Chatoorgoon K1, Pena A, Lawal T, Hamrick M, Louden E, Levitt MA. Neoappendicostomy in the management of pediatric fecal incontinence. J Pediatr Surg. 2011;46(6):1243–9.CrossRefPubMedGoogle Scholar
  12. Cho S, Moore SP, Fangman T. One hundred three consecutive patients with anorectal malformations and their associated anomalies. Arch Pediatr Adolesc Med. 2001;155(5):587–91.CrossRefPubMedGoogle Scholar
  13. Duthie HL, Gairns FW. Sensory nerve-endings and sensation in the anal region of man. Br J Surg. 1960;47:585–95.CrossRefPubMedGoogle Scholar
  14. Falcone Jr R, Levitt M, Peña A, et al. Increased heritability of certain types of anorectal malformations. J Pediatr Surg. 2007;42:124–7. discussion 127–128.CrossRefPubMedGoogle Scholar
  15. Greenwood R, Rosenthal A, Nadas A. Cardiovascular malformations associated with imperforate anus. J Pediatr. 1975;86:576–9.CrossRefPubMedGoogle Scholar
  16. Gross G, Wolfson P, Peña A. Augmented-pressure colostogram in imperforate anus with fistula. Pediatr Radiol. 1991;21:560–2.CrossRefPubMedGoogle Scholar
  17. Hamrick M, Eradi B, Bischoff A, Louden E, Peña A, Levitt MA. Rectal atresia and stenosis; unique anorectal malformations. J Pediatr Surg. 2012;47(6):1280–4.CrossRefPubMedGoogle Scholar
  18. Hassink EA, Rieu PN, Hamel BC, Severijnen RS, vd Staak FH, Festen C. Additional congenital defects in anorectal malformations. Eur J Pediatr. 1996;155(6):477–82.CrossRefPubMedGoogle Scholar
  19. Hong A, Acuna M, Peña A, et al. Urologic injuries associated with repair of anorectal malformations in male patients. J Pediatr Surg. 2002;37:339–44.CrossRefPubMedGoogle Scholar
  20. Kraus SJ. Radiologic diagnosis of a newborn with cloaca. Semin Pediatr Surg. 2016;25(2):76–81.CrossRefPubMedGoogle Scholar
  21. Levitt M, Peña A. Advances in pediatric colorectal surgery. Cloaca malformations: lessons learned from 490 cases. Sem Pediatr Surg. 2010;19(2):128–138.Google Scholar
  22. Levitt M, Patel M, Rodriguez G, et al. The tethered spinal cord in patients with anorectal malformations. J Pediatr Surg. 1997a;32:462–8.CrossRefPubMedGoogle Scholar
  23. Levitt MA1, Soffer SZ, Peña A. Continent appendicostomy in the bowel management of fecally incontinent children. J Pediatr Surg. 1997b;32(11):1630–3.CrossRefPubMedGoogle Scholar
  24. Levitt M, Stein D, Peña A. Gynecologic concerns in the treatment of teenagers with cloaca. J Pediatr Surg. 1998;33:188–93.CrossRefPubMedGoogle Scholar
  25. Nam SH, Kim DY, Kim SC. Can we expect a favorable outcome after surgical treatment for an anorectal malformation? J Pediatr Surg. 2016;51(3):421–4.CrossRefPubMedGoogle Scholar
  26. Peña A. Atlas of surgical management of anorectal malformations. New York: Springer Verlag; 1989.Google Scholar
  27. Peña A. Advances in the management of fecal incontinence secondary to anorectal malformations. Surg Annu. 1990;22:143–67.PubMedGoogle Scholar
  28. Peña A. Total urogenital mobilization – an easier way to repair cloacas. J Pediatr Surg. 1997;32:263–7. discussion 267–268.CrossRefPubMedGoogle Scholar
  29. Peña A, el Behery M. Megasigmoid: a source of pseudoincontinence in children with repaired anorectal malformations. J Pediatr Surg. 1993;28:199–203.CrossRefPubMedGoogle Scholar
  30. Peña A, Migotto-Krieger M, Levitt M. Colostomy in anorectal malformations: a procedure with serious but preventable complications. J Pediatr Surg. 2006;41:748–56. discussion 748–756.CrossRefPubMedGoogle Scholar
  31. Peña A, Grasshoff S, Levitt M. Reoperations in anorectal malformations. J Pediatr Surg. 2007;42:318–25.CrossRefPubMedGoogle Scholar
  32. Rich M, Brock W, Peña A. Spectrum of genitourinary malformations in patients with imperforate anus. Pediatr Surg Int. 1988;3:110–3.Google Scholar
  33. Rosen N, Hong A, Soffer S, et al. Rectovaginal fistula: a common diagnostic error with significant consequences in girls with anorectal malformations. J Pediatr Surg. 2002;37:961–5. discussion 961–965.CrossRefPubMedGoogle Scholar
  34. Shin YB, Ryoung KL, Kyung HP, Yong HC, Hae YK. Anorectal malformations associated with esophageal atresia in neonates. Pediatr Gastroenterol Hepatol Nutr. 2013;16(1):28–33.CrossRefGoogle Scholar
  35. Skerritt C, Tyraskis A, Rees C, Cockar I, Kiely E. Early reported rectal sensation predicts continence in anorectal anomalies. J Pediatr Surg. 2016;51(3):425–9.CrossRefPubMedGoogle Scholar
  36. Smith E, Saeki M. Associated anomalies. Birth Defects Orig Artic Ser. 1988;24:501–49.PubMedGoogle Scholar
  37. van den Hondel D, Sloots C, de Jong TH, Lequin M, Wijnen R. Screening and treatment of tethered spinal cord in anorectal malformation patients. Eur J Pediatr Surg. 2016;26(1):22–8.PubMedGoogle Scholar
  38. van der Steeg HJ, Schmiedeke E, Bagolan P, et al. European consensus meeting of ARM-net members concerning diagnosis and early management of newborns with anorectal malformations. Tech Coloproctol. 2015;19(3):181–5.CrossRefPubMedPubMedCentralGoogle Scholar
  39. Teixeira O, Malhotra K, Sellers J, et al. Cardiovascular anomalies with imperforate anus. Arch Dis Child. 1983;58:747–9.CrossRefPubMedPubMedCentralGoogle Scholar
  40. Torres R, Levitt M, Tovilla J, et al. Anorectal malformations and Down’s syndrome. J Pediatr Surg. 1998;33:194–7.CrossRefPubMedGoogle Scholar
  41. Wang C, Li L, Cheng W. Anorectal malformation: the etiological factors. Pediatr Surg Int. 2015;31(9):795–804.CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Andrea Bischoff
    • 1
  • Belinda Hsi Dickie
    • 2
  • Marc A. Levitt
    • 3
  • Alberto Peña
    • 4
    • 1
    Email author
  1. 1.International Center for Colorectal CareChildren’s Hospital ColoradoAuroraUSA
  2. 2.Colorectal and Complex Pelvic Malformation Center, Department of SurgeryBoston Children’s HospitalBostonUSA
  3. 3.Center for Colorectal and Pelvic ReconstructionNationwide Children’s HospitalColumbusUSA
  4. 4.Colorectal Center for Children, Division of Pediatric SurgeryCincinnati Children’s Hospital Medical CenterCincinnatiUSA

Personalised recommendations

Cite entry