Anorectal Malformation: Paediatric Problem Presenting in Adult

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Anorectal Malformations

Background:

• Anorectal malformation (ARM) is a congenital condition typically diagnosed in infancy.
• Late presentation of ARM in adulthood is exceptionally rare, with limited established management guidelines.
• This case involves a 22-year-old female with chronic constipation and abdominal distension due to ARM.

Purpose of the Study:

• To report a rare case of adult-onset anorectal malformation.
• To evaluate the efficacy of anal transposition as a treatment for late-presenting ARM.
• To contribute to the limited literature on adult ARM management.

Main Methods:

• Surgical intervention was performed for the diagnosed imperforate anus with vestibular fistula.
• The patient underwent anal transposition, deviating from the conventional posterior sagittal anorectoplasty (PSARP).
• Post-operative follow-up included assessment of functional outcomes using the Kelly's score.

Main Results:

• The patient presented with symptoms of abdominal distension, vomiting, and chronic constipation since birth.
• Perineal examination confirmed imperforate anus with vestibular fistula, indicative of ARM.
• Two years post-anal transposition, the patient demonstrated satisfactory outcomes with a Kelly's score of six.

Conclusions:

• Anal transposition can be a viable and effective surgical option for adult patients with late-presenting anorectal malformation.
• This case suggests that anal transposition yields satisfactory results in managing adult ARM.
• Further research is warranted to establish optimal management strategies for adult ARM.