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ORIGINAL ARTICLE
Year : 2012  |  Volume : 1  |  Issue : 3  |  Page : 122-125

A collective review of cases with imperforate anus managed in a teaching hospital


Department of Surgery, Division of Pediatric Surgery, King Abdul Aziz University Hospital, Jeddah 21589, Saudi Arabia

Correspondence Address:
Jamal S Kamal
Department of Surgery, King Abdul Aziz University Hospital, PO Box 80215, Jeddah 21589
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-0521.106080

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Objectives: The current study aimed to review the cases of imperforate anus, their demographic distribution, associated anomalies, results of management, and defining cases that require further management. Materials and Methods: A total of 123 cases of different types of imperforate anus were managed over a period of 20 years. Results: The patient group comprised 70 males and 53 females. Recto-vestibular fistula was the commonest type seen (27%), followed by ano-perineal fistula (20%). Only two cases of cloaca (1.6%) and one iatrogenic recto-vaginal fistula were seen. The commonest associated anomaly was hypospadius (79.6%) in males, followed by hydronephrosis and abnormal sacrum in both sexes. Most cases were managed by posterior sagittal anorectoplasty (72%). Voluntary bowel control and fecal continence were found in 100% of cases with ano-perineal fistula, in 93.3% of cases with recto-vestibular fistula, and in 63% of those with recto-urethral fistula. Fecal soiling was found in 12 patients; three of them had sacral anomalies and they were offered Malone appendicostomy. Eleven patients had mucosal prolapse; in two of them the prolapse was complete. Five patients possessed mislocated anus but kept clean by daily enemas and diet control. Conclusions: Although the number of cases with imperforate anus treated in our hospital was relatively small, the outcome of management was favorable and matching with reports from specialized centers. It is advisable to keep those patients under regular follow-up and updating their contact information frequently for further assistance.


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