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Access to essential paediatric surgery in the developing world: a case of imperforate anus with rectovaginal and

Marilyn L Vinluan1, Remigio M Olveda1, Clive K Ortanez2

  • 1Department of Health, RITM, Manila, Philippines.

BMJ Case Reports
|October 23, 2015
PubMed

Insights

This case report details a rare imperforate anus with rectovaginal and rectocutaneous fistulas in a 6-year-old girl. It highlights healthcare system and socioeconomic barriers to timely diagnosis and treatment of anorectal malformations.

Area of Science:

  • Pediatric Surgery
  • Medical Genetics
  • Public Health

Background:

  • Anorectal malformations (ARMs) are congenital conditions affecting the distal anus, rectum, and potentially genitourinary tracts.
  • Early diagnosis and prompt surgical repair are crucial for optimal functional outcomes in patients with ARMs.
  • ARMs present a spectrum of anomalies requiring tailored management strategies.

Observation:

  • A rare case of imperforate anus with associated rectovaginal and rectocutaneous fistulas is presented in a 6-year-old Filipino girl.
  • The patient's delayed diagnosis and treatment were attributed to healthcare system deficiencies and socioeconomic factors.
  • This case underscores the challenges in managing congenital anomalies in resource-limited settings.

Findings:

  • The complex ARM presentation required specialized surgical intervention.
  • Delayed presentation significantly impacted the potential for optimal functional recovery.
  • Healthcare access and socioeconomic status were identified as critical determinants in timely management.

Implications:

  • Highlights the need for improved diagnostic capabilities and accessible healthcare for congenital anomalies in low-resource settings.
  • Emphasizes the importance of addressing socioeconomic barriers to ensure timely medical intervention for birth defects.
  • Suggests strategies for early detection and management of anorectal malformations to improve patient outcomes globally.

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