Medical Q&As

Imperforate anus - treatment?

My daughter was born with imperforate anus. I want to know if she has to get surgery will it hurt her and will she be hospitalised for long. Also what are the long term effects?

Infants with imperforate anus have malformations of the rectum and anus that result in the growth of skin over the anus accompanied by varying degrees of incomplete development of the rectum. This congenital defect can occur as a solitary abnormality but may occur in conjunction with a variety of other congenital abnormalities. The incidence of these additional abnormalities increases with the severity of the imperforate anus. Some types of imperforate anus require very complex surgery whereas others are more straighforward. The location of the level of the abnormality in the rectum is one of the key factors in deciding on the surgical approach. There are two categories of imperforate anus; a high type and a low type. The “high type” imperforate anus means that the rectum is too short and does not extend below the level of the pelvic floor muscles whereas the “low type” means that the rectum extends below that level. In the case of the high type it is usually necessary to fashion a colostomy for the child so that the bowels can be evacuated. A more definitive procedure is deferred for a few months until the child has grown a little more. The low type may simply require a procedure known as a perineal anoplasty, which means re-fashioning the anal orifice. This latter situation is the commonest scenario and such children have a good prognosis and have good control of their bowels. In the more complex scenario there may be difficulties in establishing satisfactory bowel control. To address your specific situation; your child will undergo the repair under deep anaesthesia and will not feel any discomfort during the procedure. With the less complex type of repair you could expect that your child will be discharged from hospital within a few days. With the more complex type of surgery that period of time would be longer. If your child has a low type imperforate anus and only requires an anoplasty her prognosis should be excellent.