ABSTRACT
This chapter establishes the diagnosis/type of anorectal malformation (ARM) that the infant has is the most important first step when managing a child, after initial resuscitation and basic care. Without a clear understanding of the defect, it is impossible to make informed decisions with regards to the ongoing needs of the child. The male ARM patient can have: Perineal fistula; Rectourethral fistula; Bulbar, prostatic, bladder neck which correspond to levels of the fistula to the urinary tract; Recto-bladder fistula; No fistula; Anal or rectal stenosis; Rectal atresia; and Cloacal exstrophy. The diagnosis can be made on simple clinical examination in the majority of cases. The more complex malformations will require further investigations before one can identify the type of ARM the male infant has. In the AP view, it is difficult to draw the lines accurately, and once again the sacrum/coccyx appears to be absent, in this case due to the tilt of the pelvis when the radiograph was taken.
