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Anorectal malformation presenting as Hirschsprung's disease: a case report
1Muhimbili Medical Centre, University of Dar es Salaam, Tanzania.
A 3.8 kg female baby, who was born on 7-2-92 by normal vaginal delivery at a zonal hospital in the Southern Highlands of Tanzania, was initially noted to have had an "ectopic" anus (an ano-perineal fistula) but was otherwise normal. She had delay in the passage of meconium upto the third day, and by the fifth day had developed marked abdominal distension. Following a period of unsuccessful saline "enemas" she had to undergo a right transverse colostomy in the fourth week (which relieved the distension) for what was then presumed to be Hirschsprung's Disease. She was referred to the National Referral hospital in Dar es Salaam a year later, where she was found to have an entirely intra-pelvic sacrococcygeal teratoma in association with a "low" anorectal malformation. This unusual case is of interest because of the rare association of intrapelvic sacrococcygeal teratoma with anorectal malformation which led to the initial mis-diagnosis of hirschsprung's disease.
A 3.8 kg female baby, who was born on 7-2-92 by normal vaginal delivery at a zonal hospital in the Southern Highlands of Tanzania, was initially noted to have had an "ectopic" anus (an ano-perineal fistula) but was otherwise normal. She had delay in the passage of meconium upto the third day, and by the fifth day had developed marked abdominal distension. Following a period of unsuccessful saline "enemas" she had to undergo a right transverse colostomy in the fourth week (which relieved the distension) for what was then presumed to be Hirschsprung's Disease. She was referred to the National Referral hospital in Dar es Salaam a year later, where she was found to have an entirely intra-pelvic sacrococcygeal teratoma in association with a "low" anorectal malformation. This unusual case is of interest because of the rare association of intrapelvic sacrococcygeal teratoma with anorectal malformation which led to the initial mis-diagnosis of hirschsprung's disease.