DOI link for Anorectal Malformations
Anorectal Malformations book
Anorectal malformations (ARM) encompass a class of congenital malformations that range from minor defects to severe defects that can lead to lifelong bowel management difficulties. ARM is a relatively frequent abnormality of hindgut development with an estimated incidence of 1 in 2500 live births. Often ARM patients have associated anomalies. Genitourinary tract defects including vesicoureteral reflux which can occur in up to 60% of patients. When initially faced with a newborn with an anorectal anomaly, it is often best to wait 24 hours to determine the type of anomaly and therefore the type of treatment needed. The diagnostic work-up includes an abdominal radiograph, placement of a nasogastric tube, echocardiogram to rule out cardiac disease, a renal ultrasound, a spinal ultrasound, and a radiograph of the entire spine including the sacrum. Classically rectourethral fistulas are both treated with a colostomy in the first few days of life at the junction of the descending colon and sigmoid colon.