Skip to main content

Anorectal Malformations

  • Living reference work entry
  • Latest version View entry history
  • First Online:
Pediatric Surgery

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  • 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.

    Article  CAS  Google Scholar 

  • Bianchi D, Crombleholme T, D’Alton M. Cloacal exstrophy. New York: McGraw-Hill; 2013.

    Google Scholar 

  • 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 

  • Bischoff A, Levitt MA, Peña A. Bowel management for the treatment of pediatric fecal incontinence. Pediatr Surg Int. 2009;25(12):1027–42.

    Article  Google Scholar 

  • Bischoff A, Levitt MA, Breech L, Louden E, Peña A. Hydrocolpos in cloacal. Malformations. J Pediatr Surg. 2010;45(6):1241–5.

    Article  Google Scholar 

  • Bischoff A, Levitt MA, Peña A. Laparoscopy and its use in the repair of anorectal malformations. J Pediatr Surg. 2011;46(8):1609–17.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Brenner E. Congenital defects of the anus and rectum. Surg Gynecol Obstet. 1975;20:579–98.

    Google Scholar 

  • Casaccia G, Catalano OA, Bagolan P. Congenital gastrointestinal anomalies in anorectal malformations: what relationship and management? Congenit Anom (Kyoto). 2009;49(2):93–6.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  CAS  Google Scholar 

  • Duthie HL, Gairns FW. Sensory nerve-endings and sensation in the anal region of man. Br J Surg. 1960;47:585–95.

    Article  CAS  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Greenwood R, Rosenthal A, Nadas A. Cardiovascular malformations associated with imperforate anus. J Pediatr. 1975;86:576–9.

    Article  CAS  Google Scholar 

  • Gross G, Wolfson P, Peña A. Augmented-pressure colostogram in imperforate anus with fistula. Pediatr Radiol. 1991;21:560–2.

    Article  CAS  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  CAS  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Kraus SJ. Radiologic diagnosis of a newborn with cloaca. Semin Pediatr Surg. 2016;25(2):76–81.

    Article  Google Scholar 

  • 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 

  • Levitt M, Patel M, Rodriguez G, et al. The tethered spinal cord in patients with anorectal malformations. J Pediatr Surg. 1997a;32:462–8.

    Article  CAS  Google Scholar 

  • Levitt MA1, Soffer SZ, Peña A. Continent appendicostomy in the bowel management of fecally incontinent children. J Pediatr Surg. 1997b;32(11):1630–3.

    Article  CAS  Google Scholar 

  • Levitt M, Stein D, Peña A. Gynecologic concerns in the treatment of teenagers with cloaca. J Pediatr Surg. 1998;33:188–93.

    Article  CAS  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Peña A. Atlas of surgical management of anorectal malformations. New York: Springer Verlag; 1989.

    Google Scholar 

  • Peña A. Advances in the management of fecal incontinence secondary to anorectal malformations. Surg Annu. 1990;22:143–67.

    PubMed  Google Scholar 

  • Peña A. Total urogenital mobilization – an easier way to repair cloacas. J Pediatr Surg. 1997;32:263–7. discussion 267–268.

    Article  Google Scholar 

  • Peña A, el Behery M. Megasigmoid: a source of pseudoincontinence in children with repaired anorectal malformations. J Pediatr Surg. 1993;28:199–203.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Peña A, Grasshoff S, Levitt M. Reoperations in anorectal malformations. J Pediatr Surg. 2007;42:318–25.

    Article  Google Scholar 

  • Rich M, Brock W, Peña A. Spectrum of genitourinary malformations in patients with imperforate anus. Pediatr Surg Int. 1988;3:110–3.

    Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Smith E, Saeki M. Associated anomalies. Birth Defects Orig Artic Ser. 1988;24:501–49.

    CAS  PubMed  Google Scholar 

  • 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.

    PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Teixeira O, Malhotra K, Sellers J, et al. Cardiovascular anomalies with imperforate anus. Arch Dis Child. 1983;58:747–9.

    Article  CAS  Google Scholar 

  • Torres R, Levitt M, Tovilla J, et al. Anorectal malformations and Down’s syndrome. J Pediatr Surg. 1998;33:194–7.

    Article  CAS  Google Scholar 

  • Wang C, Li L, Cheng W. Anorectal malformation: the etiological factors. Pediatr Surg Int. 2015;31(9):795–804.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alberto Peña .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer-Verlag GmbH Germany, part of Springer Nature

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Bischoff, A., Dickie, B.H., Levitt, M.A., Peña, A. (2019). Anorectal Malformations. In: Puri, P. (eds) Pediatric Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-38482-0_76-2

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-38482-0_76-2

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-38482-0

  • Online ISBN: 978-3-642-38482-0

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics

Chapter history

  1. Latest

    Anorectal Malformations
    Published:
    23 April 2019

    DOI: https://doi.org/10.1007/978-3-642-38482-0_76-2

  2. Original

    Anorectal Malformations
    Published:
    07 March 2017

    DOI: https://doi.org/10.1007/978-3-642-38482-0_76-1