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[Validity of simple X-ray-techniques in misdiagnosed anorectal malformations (author's transl)]
Insights
Anterior perineal anus, a type of anorectal malformation, is often missed in newborns but causes chronic constipation later. Characteristic findings on irrigoscopy aid early diagnosis and surgical intervention.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Neonatal Medicine
Background:
- Anorectal malformations (ARMs) are congenital anomalies affecting the distal anus and rectum.
- Anterior perineal anus, a specific ARM, is often asymptomatic in neonates due to easy defecation.
- Dietary changes post-infancy can unmask this condition, leading to chronic constipation.
Purpose of the Study:
- To highlight the diagnostic challenges of anterior perineal anus in neonates.
- To describe the characteristic radiographic findings of anterior perineal anus on irrigoscopy.
- To emphasize the importance of early diagnosis and surgical correction.
Main Methods:
- Retrospective analysis of cases with anterior perineal anus.
- Review of clinical presentation and diagnostic imaging (irrigoscopy).
- Correlation of radiographic findings with clinical outcomes.
Main Results:
- Anterior perineal anus is frequently overlooked in the neonatal period.
- Symptoms of chronic constipation typically manifest after dietary diversification.
- Lateral view irrigoscopy reveals specific signs: horizontal rectal limitation, dorsal pouch, beak-shaped fistula, and elevated anorectal junction.
Conclusions:
- Early identification of anterior perineal anus is crucial to prevent long-term complications like chronic constipation.
- Characteristic irrigoscopy findings are key to accurate diagnosis.
- Prompt surgical intervention is recommended upon diagnosis.
Abstract:
One particular form of an anorectal malformation--the anterior perineal anus--is frequently overlooked in the neonate period because defecation is easy at this age. However, with the change of diet, this malformation as a rule leads to chronic constipation. The lateral view at the beginning of an irrigoscopy usually shows a characteristic picture of a horizontal caudal limitation of the rectum, a dorsal pouch, a beakshaped fistula and an elevation of the anorectal transition. These findings contribute essentially to the clinical diagnosis and permit early operation.