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Perineal lipomas associated with anorectal malformations
Tomas Wester1, Risto J Rintala
1Department of Paediatric Surgery, University Children's Hospital, 751 85, Uppsala, Sweden. tomas.wester@surgsci.uu.se
Pediatric Surgery International
|September 27, 2006
Summary
Perineal lipomas are rare in newborns with anorectal malformations but can complicate surgical repair. These lipomas may negatively impact long-term bowel function and sphincter anatomy.
Area of Science:
- Pediatric Surgery
- Congenital Abnormalities
- Surgical Outcomes
Background:
- Anorectal malformations (ARMs) are congenital conditions requiring surgical correction.
- Perineal lipomas are rare, associated lesions that can complicate ARM repair.
- Limited data exists on the functional impact of perineal lipomas in ARMs.
Observation:
- A retrospective review of six patients with ARMs and perineal lipomas treated between 1991-2005.
- Patients included males with high ARMs and females with rectovestibular fistulas or cloaca.
- Lipomas were excised during ARM reconstruction; bowel function assessed in older children.
Findings:
- Perineal lipomas were excised concurrently with ARM reconstruction.
- Post-operative bowel function was evaluated in three patients.
- Two patients required an antegrade continence enema (ACE) stoma for constipation and soiling; one patient experienced ongoing soiling.
Implications:
- Perineal lipomas, though rare, can distort sphincter anatomy in patients with ARMs.
- Excision of lipomas during initial ARM reconstruction is recommended.
- These associated lipomas may compromise long-term bowel function, necessitating further investigation.
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