ABSTRACT
Bowel control depends on the integrity and normal function of three important elements: sensation, sphincters, and colonic and rectosigmoid motility. Anal canal sensation is responsible for providing exquisite sensation, capable of discriminating solid from gas and discerning liquid particles in minute dimensions. The anal canal is absent in most types of anorectal malformations. Most patients with anorectal malformations have different degrees of development of muscle structures, and therefore they have different degrees of rectal proprioception. The contrast enema shows the presence of a severe segmental dilatation of the sigmoid. In addition, the patients suffer from constipation. Most patients with anorectal malformations have an abnormally dilated rectum at its most distal segment. At one extreme of the spectrum is the patient who was born with a benign anorectal malformation; for these patients most surgeons predict a good outcome provided they receive a good operation by an experienced surgeon.
