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Associated congenital anomalies: vestibular fistula, duodenal atresia and obstructive refluxing megaureter

Svetlana Bukarica1, Smiljana Marinković, Vladimir Borisev

  • 1Institut za zdravstvenu zastitu dece i omladine, Novi Sad.

Medicinski Pregled
|August 19, 2005
PubMed

Insights

This case report details a newborn with multiple congenital anomalies, including duodenal atresia and imperforate anus. Surgical interventions led to normal growth and development, achieving fecal continence and resolving urinary issues.

Area of Science:

  • Pediatric Surgery
  • Neonatal Medicine
  • Medical Genetics

Background:

  • Congenital gastrointestinal anomalies present a spectrum of malformations, often co-occurring with other organ system defects.
  • Infants with imperforate anus frequently exhibit associated genitourinary, cardiovascular, gastrointestinal, and vertebral anomalies (50-60%).

Purpose of the Study:

  • To present a case report of a female newborn diagnosed prenatally with duodenal atresia and right hydronephrosis.
  • To illustrate the diagnostic and therapeutic management of complex congenital gastrointestinal and genitourinary anomalies in a neonate.

Main Methods:

  • Prenatal diagnosis of duodenal atresia and right hydronephrosis.
  • Clinical investigation revealing imperforate anus with vestibular fistula.
  • Diagnostic imaging including plain abdominal X-ray (double-bubble sign) and ultrasound with intravenous pyelography.
  • Surgical interventions: intraluminal membrane excision, sigmoid colostomy, ureteral tapering and reimplantation, posterior sagittal anorectoplasty, and colostomy closure.

Main Results:

  • Successful surgical correction of duodenal atresia and imperforate anus with vestibular fistula.
  • Management of right hydronephrosis and obstructive megaureter.
  • The patient achieved normal growth and development, normal bowel control, fecal continence without soiling, and resolution of urinary infections.

Conclusions:

  • Complex congenital gastrointestinal and genitourinary anomalies require a multidisciplinary approach and timely surgical intervention.
  • Early and comprehensive management can lead to favorable long-term outcomes, including normal development and functional recovery.

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