Anorectal malformation incidence and significance of associated anomalies

ABSTRACT

To determine the incidence and types of associated anomalies in children with anorectal malformations. One hundred and sixteen patients, with anorectal malformations seen at King Hussein Hospital between 1982-1996, were reviewed for associated genitourinary and other systems anomalies. Assessment of these anomalies was done by clinical, radiological, sonography and isotope scan. Out of 116 patients with anorectal malformation, high imperforate anus was found in 44.8% [male 42, female 10], and low anorectal anomaly in 55.2% [male 26, female 38]. Genitourinary abnormalities were encountered in 38 patients. Associated congenital defects were seen in 45 patients Urinary tract [24%], Cardiac [4.3%], Sacrum and vertebral deficit [8.6%], Genital [8.6%], Limbs [9.4%], Cloaca [5%], Esophageal Artesia [5%], Down's syndrome [3.4%], Hydrocephalus [1.7%], Potter syndrome [0.8%], and others [10.3%]. We observed that the incidence of associated anomalies was highest in males with high anorectal malformations [56%], and lowest [10%] in those females with low anorectal anomaly. Of the hundred and sixteen patients, 68 were males and 48 were females. The genitourinary tract is the most serious and the commonest site to have associated defects in patients with anorectal malformations. The higher the malformation the more frequent is the associated anomalies with severe urologic problem. Early diagnosis and treatment should be carried out to prevent sequale of fatal associations