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Transcript of Imperforate Anus
limb anomalies The dominant issues lie within the rectum, vagina, and urinary tract. Treatment: Symptoms: Anal opening very near the vagina opening in girls
Baby does not pass first stool within 24 - 48 hours after birth
Missing or moved opening to the anus
Stool passes out of the vagina, base of penis, scrotum, or urethra
Swollen belly area The treatment of this occurrence can be done surgically and typically has no further complications. If the rectum is connected with other organs than those must also be operated on. The surgery for the imperforate anus is required immediately. An example picture: The means of treatment are dependent upon
the severity of the newborn's condition.
In mild cases, the procedure includes a surgical
process in which the anus is widened. Afterward,
stool softeners are necessary for the process of relieving
the feces. The surgery is called anoplasty, which includes closing any fistulas, creating an anal opening, and putting the rectal pouch into the anal opening. In more severe cases the surgeon will choose to do a procedure called colostomy. An opening in the skin and muscle of the abdomen wall will be made and the large intestine will be attached so that the stools may drain into a bag. The baby is then left to develop more before taking any further medical decisions. The second procedure is where a cut will be made in the abdomen, and the surgeon will detach and move the colon to a more proper position. Next, a cut is made in the anal area in order to pull the rectal pouch down and in turn, create an anal opening. With any procedure comes the risk of
complications. Damage can occur within the urethra (tube that carries urine out of the bladder) and the ureter (tube that carries urine from the kidneys to the bladder.) Other complications that may proceed surgery include a hole that can develop within the wall of the intestine, abnormal connections between the anus and vagina, long-term complications with bowel movements due to the damage of nerves and muscles (constipation), and temporary paralysis of the bowel. Risks & Complications: Once the procedure is completed, the baby may be able to go home that very day, depending on the severity of the condition and the results of the surgery. A health care provider will use a tool to widen and stretch the anal opening to improve the muscle tone and prevent further narrowing. This technique will be continually initialized within the following months to improve the opening and prevent narrowing. Different forms of an imperforate anus include:
the rectum may end in a blind pouch that does not connect to the colon.
the rectum may have openings to the urethra, bladder, penis, vagina, or all three (persistent cloaca)
there may be a narrowing of the anus or no anus at all. Most defects can be corrected with surgery. In some cases, constipation can be a continuing problem. Most children who have received the more complex surgeries still have control over their bowel movements, but must follow a program that includes high-fiber foods, stool softeners, and sometimes the usage of enemas (liquids introduced through the anus). In some cases, the child may need a follow up surgery, and in rare cases, will need close medical attention for life. With this taken into consideration, this prognosis only considers the malformation of the anus and does not include any other birth defects that may coincide. Prognosis: *It is very crucial to determine any underlying issues as soon as possible to avoid any further sequelae. Estimated occurrence of 1 in 5000
Sonography can be utilized to determine the type of imperforate anus.
The cause of this anomaly is unknown which means their is no known prevention.
The surgery is done under general anesthesia.
In most cases, surgery does indeed prove successful. Other important facts include: Bhimji, Shabir (MD, PhD), "Imperforate Anus Repair." Medline Plus. American Accredidated Healthcare Commission. <http://www.nlm.nih.gov/medlineplus/ency/article/002926.htm>
"Imperforate Anus." PubMed Health. A.D.A.M Encyclopedia. <http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002132/>
"Imperforate Anus." Wikipedia. <http://en.wikipedia.org/wiki/Imperforate_anus> References: