What is
an imperforate anus?
Imperforate anus is a congenital
(present from birth) defect in which the opening to the anus is missing or blocked.
Imperforate anus may occur in several
forms. The rectum may end in a blind pouch that does not connect with the
colon. Or, it may have openings to the urethra, bladder, to the base of penis
or scrotum in boys, or to the vagina in girls. There may also be stenosis (narrowing) or a
complete absence of the anus. The problem is caused by abnormal development of
the fetus, and may be associated with other birth defects.Imperforate anus is a relatively common
condition that occurs in about 1 out of 5,000 infants.
Symptoms
- No passage of first stool within 24 - 48 hours after
birth
- Stool passes out of the vagina, base of penis, scrotum,
or urethra
- Swollen belly
Diagnosis
A doctor can diagnose this condition
during a physical exam. Imaging tests may be recommended to determine which
structures are abnormally connected or absent, and to plan for surgical repair.
Treatment
The infant should be checked for
other problems, especially those affecting the genitals, urinary tract, and
spine. Surgical reconstruction of the anus is often needed. If the rectum
connects with other organs, repair of these organs will also be necessary
through abdominal surgery. A temporary colostomy is often required. When a
colostomy is performed, the large intestine is cut and brought to an opening that
is made through the wall of the abdomen. This allows bowel contents to empty into a
bag. Later, when the repairs to the child’s
organs have healed, the colostomy is removed to allow the child to pass normal
bowel movements.
Recovery
With treatment, the outcome is
usually good. However, it depends on the exact type and severity of the
problem. Some infants may never develop adequate bowel control.
The Division of Pediatric General Surgery treats imperforate anus at Hopkins Children's.