ABSTRACT
This chapter presents a case study of an infant with ARM with a reported no fistula defect. It shows that a 2-month-old male infant with an anorectal malformation (ARM) with referring institution that he has an ARM with no fistula. No meconium was seen on the perineum or in the urine by 12 hours of age and he was managed initially with a colostomy and mucous fistula. He has trisomy 21. His VACTERL screening was negative apart from a small atrial septal defect (ASD) on echocardiogram. If there is meconium on the perineum, it is a perineal fistula, and a primary posterior sagittal anorectoplasty can be performed if the infant is clinically well. The rectum will not be reached through a posterior sagittal incision and will require transabdominal mobilization, ideally laparoscopically. Rectum is opened above the position of the fistula, and is opened further until the fistula is seen. This is marked with a silk stay suture.
