Anomalies Anorectal Flashcards

1
Q

Anomalies Anorectal

A

Occur in 1\4000 neonates, male > female , most common defect in boys is a rectourethral fistula, most common defect in girls is rectovestibular fistula

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2
Q

Low type problem

A

Stenosis

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3
Q

High type problem

A

incontinence

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4
Q

Types of imperforate anus

A
  1. Low types.
  2. Inter mediate.
  3. High type.
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5
Q

Clinical features: examination of:-

A

Perineum

❖ Look for presence of anus , its size & site
❖ Look for presence of an anal dimple
❖ If there is an impulse on crying at the site of the anus , it denotes a low a normal
❖ In ectopic anus, there is a subcutaneous fistulous tract full of meconium .
❖ Meconium at the tip of the penis denotes a fistula to the bladder or urethra .

Abdomin
There may be evidence of intestinal obst.

General exam.
To exclude associated congenital Anomaly.

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6
Q

Investigation

A

Plain abdominal X – ray in the inverted position (invertogram).

The distance between radio opaque mark & the distal gas shadow is

Measured If the distance > 1cm —– high anomaly If the distance < 1cm —– low anomaly

Urine is examined for the presence of meconium , if present this denote a fistulous communication

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7
Q

Treatment

A
  1. All ano rectal anomalies can be corrected by posterior sagittal
  2. Approach with or without laparotomy
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8
Q

Persistent cloaca

A

A defect in which rectum, vagina, urinary tract meet & fuse into a single common channal & absence of hymen, the length of common channel varies from 1 – 7 cm .

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