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Updated: May 20, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Delayed presentation of anorectal malformation for definitive surgery
Shilpa Sharma1, Devendra K Gupta
1Department of Pediatric Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India. drshilpas@gmail.com
Aim:
To retrospectively study the outcome of patients with anorectal malformations (ARM) presenting late for definitive procedure.
Methods:
Patients with ARM presenting beyond 5 months of age managed from January 2008 to March 2012 were studied for clinical outcome.
Results:
Ages at presentation varied from 5 months to 14 years, seven patients were older than 5 years of age. Of the 36 cases, 5 patients (3 boys and 2 girls) had presented with colostomy done elsewhere. Four patients had high anomalies. Of the 33 girls, 14 had rectovestibular fistula and 9 had anovestibular fistula. Bowel preparation with peglec was used in patients without colostomy. Preoperative retention enemas, laxatives and Hegar dilators were used for 3-11 days before surgery. On table irrigation was required in four. Patients without a covering colostomy were kept nil per oral for 5 days following surgery in prone/lateral position. Two patients had mild post-op wound infection, and were managed with local care.
Conclusion:
Delayed presentation of ARM especially in girls is quite common in developing countries. With proper perioperative care, these cases may be managed successfully with a single stage procedure in most cases. The mature tissue growth with age allows proper tissue dissection and good repair of the perineal body in girls.
