An anorectal malformation
(also called imperforate anus) is a birth defect that affects the development of the rectum and anus. Development of the urinary structures, and genital tract may also be affected. This is accompanied by abnormal formation of muscles and nerves of the pelvic floor that control emptying of stool.
Anorectal malformations involve a wide spectrum of defects. Imperforate anus is when there is no opening at the end of the digestive tract, where the anus is normally located. The rectum (the end of the colon) may end in a closed pouch in the body, or it may connect to the genitourinary tract; this is called a fistula. Sometimes the anus is small and in an abnormal position on the bottom, which prevents natural passage of stool; this is called an anterior anus or perineal fistula. A persistent cloaca is a complex malformation in which the rectum, vagina, and urinary tract meet in a common channel. In children born with cloaca, only one opening will be visible in the perineum compared to the normal anatomy which has 3 separate openings. (see image gallery to the right for medical illustrations and descriptions.)
Children born with an anorectal malformation may have other problems associated with the condition.
Most babies with an anorectal malformation will need one or more operations to repair the problem. Children may also need surgery for associated malformations. The purpose of surgery is to allow a way for the stool to come out of the body. Our team of pediatric surgeons will evaluate your child and decide the best treatment option.
Patients with imperforate anus will be followed closely throughout childhood and adolescence, with some patients being followed into adulthood. The most common problems for these children are constipation and fecal incontinence (the inability to hold stool). Other problems may involve urinary tract or renal function. At the Colorectal Center at Primary Children’s Hospital we address ongoing problems and coordinate care between specialists to manage your child’s needs. We provide a Bowel Management Program
, where we work closely with you and your child to assess function and provide a way for your child to stay clean of stool and prevent accidents.