| ID | 409 |
|---|---|
| Name | IMPERFORATED ANUS |
| Cause | |
| Signs Symptoms | |
| Diagnosis | Diagnosis & management: A. Low variety - Visual and manual testing of the patency of the anus of every infant at birth is sufficient to diagnose the low variety imperforated anus. Covered anus- the underlying anal canal is covered by a bar of skin with a track running forward to the perinea! raphe. Track should be opened with scissor, followed by routine dilatation of the anus. Ectopic anus- the anus is situated anteriorly and may open in the perinium in boys or more commonly in the vulva in girls. A plastic ‘cut back’ operation is required. Stenosed anus- careful examination usually reve-als a minute opening. Regular dilatation is enough. Membranous stenosis- the anus is covered with a thin membrane which bulges with retained meconium. An incision will cure the condition. B. High variety-Patient may come with rapidly developing bile stained vomiting and abdominal distension or meconium may be seen to exude to the vagina, urethra or perinium. X-ray examination- X-ray of neonate helding upside down, with a metal botton or lead marker inserted into the blind anal canal. The gas of the rectum will rise to the top and indicate the distance between the site of the metalic indicator and the blind end of the rectum. If the distance is over 2.5 cm, the abnormality is ‘high’ one. Surgery- colostomy is the choice of surgery for cloacal variety. Laparotomy, division of fistula and ‘pull through’ operation in one stage or in later stage is the choice of surgery in rectal atresia or anorectal agenesis. In this condition one portion of the gut becomes invaginated into .immediatly adjacent another, leading to intestinal obstruction. It is the most common cause of intestinal obstruction between 3 months to 6 years of age. |
| Investigations | |
| Management | Diagnosis & management: A. Low variety - Visual and manual testing of the patency of the anus of every infant at birth is sufficient to diagnose the low variety imperforated anus. Covered anus- the underlying anal canal is covered by a bar of skin with a track running forward to the perinea! raphe. Track should be opened with scissor, followed by routine dilatation of the anus. Ectopic anus- the anus is situated anteriorly and may open in the perinium in boys or more commonly in the vulva in girls. A plastic ‘cut back’ operation is required. Stenosed anus- careful examination usually reve-als a minute opening. Regular dilatation is enough. Membranous stenosis- the anus is covered with a thin membrane which bulges with retained meconium. An incision will cure the condition. B. High variety-Patient may come with rapidly developing bile stained vomiting and abdominal distension or meconium may be seen to exude to the vagina, urethra or perinium. X-ray examination- X-ray of neonate helding upside down, with a metal botton or lead marker inserted into the blind anal canal. The gas of the rectum will rise to the top and indicate the distance between the site of the metalic indicator and the blind end of the rectum. If the distance is over 2.5 cm, the abnormality is ‘high’ one. Surgery- colostomy is the choice of surgery for cloacal variety. Laparotomy, division of fistula and ‘pull through’ operation in one stage or in later stage is the choice of surgery in rectal atresia or anorectal agenesis. In this condition one portion of the gut becomes invaginated into .immediatly adjacent another, leading to intestinal obstruction. It is the most common cause of intestinal obstruction between 3 months to 6 years of age. |
| Introduction | This is relatively common emergency. In female infants there is frequently associated rectovaginal fistula and in males a fistula to the bladder or urethra may be present. |
| History | |
| Etiology | |
| Clinical Features | |
| Preventions | |
| Treatment | |
| Complications | |
| Prognosis | |
| Types | Type: The condition is devided into two main groups- A. High varieties- 1. Ano-rectal agenesis. 2. Rectal atresia. 3. Cloaca. B. Low varieties-\. Covered anus. 2. Ectopic anus. 3. Stenosed anus. 4. Membranous stenosis. The low varieties are easy to diagnose, simple to treat and outlook is good. Whereas high varieties often have a fistula into the urinary tract togather with a deficient pelvic floor and the prognosis is not good. |
| Classification | |
| Observation | |
| Pathology |
© Pakistan Drug Directory. All Rights Reserved.
Designed By: Pakistan Drug Directory Team