Document Type : Original Article
Authors
1
FIBMS pediatric surgery, Assistant professor, University of Basrah, Al-Zahraa College of Medicine, Department of Surgery, iraq
2
FIBMS pediatric surgery, Professor, University of Basrah, Al-Zahraa College of Medicine, Department of Surgery, Iraq
3
FIBMS (Pediatrics), Basrah Children Specialty Hospital, Basrah, Iraq
10.22038/ijn.2024.75632.2456
Abstract
Background: Anorectal malformations are the most common congenital anomalies of the gastrointestinal tract in pediatric surgical patients. The aim of this study is to determine the prevalence, demography, types, mode of presentation of anorectal malformations in our society. The secondary aim is to estimate the associated anomalies, and postoperative complications.
Methods: A retrospective study was done on all cases of anorectal malformations admitted in our pediatric surgery center between on December 2017 till December 2022. One hundred four (104) patients were included in this study. Information regarding the demographic, clinical and the outcome are all studied.
Results: The incidence of anorectal malformations was 1.029 per 5000 live births. The male: female ratio was 2:1. Early presentations (in the first 3 days of life) were seen in 85.5% of male patients and 37.1% of female patients. History of prematurity was found in 14.5% of the male patients and 20% of the females. The most common type of anorectal malformations in male patients was rectourethral fistula (63.8%), while in females was rectovestibular fistula (65.7%). Associated anomalies were observed in 41.3% of patients. Genitourinary anomalies were the predominant anomalies (10.6%). Eighty-seven (83.7%) patients were treated by initial colostomy and posterior sagittal anorectoplasty thereafter, while minimal anoplasty was performed in only 16.3% of patients. Postoperative complications were reported in 47% of patients, constipation was the most prevalent (45.2%), followed by incontinence (37.5%).
Conclusions: Anorectal malformations are relatively common in our society. The incidence is nearly twice in boys. The diagnosis is late in the majority of female patients. High incidence of associated anomalies was recorded. Constipation is the most common late complication. Continence outcome is acceptable in majority of patients.
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