A study on Etiology and incidence of formation of types of Anorectal malformation: A prospective study

Abstract

Background: Anorectal malformations are one of the most common congenital defects. This study was undertaken to study the hospital incidence of anorectal malformations (ARM), frequency of various types of defects, their sex distribution and the spectrum of anomalies associated with ARM. Materials and Methods: Ninety consecutive children attending the paediatric surgery department were included in this study. A detailed history was taken, and examination was performed for the primary as well as the associated defects. Appropriate investigations like invertogram, cologram were done wherever indicated. Management was as per the standard protocol. The data was recorded and analyzed. Results: Out of the 90 patients, 52(57.77%) male patients and 38(42.22%) female patients. Most of our patients presented within first 24 hours of life. Patients who presented after 72 hours were either female patients with anovestibular malformation or male patients with anocutaneous fistula. In the present study, High anomalies are the most common anorectal malformation in this study. Cardiac and Urological abnormalities are the most common associated anomalies with anorectal malformation. In this study we have performed ultra sound in all and voiding cystourethrogram in 87/90 patients. In 29 patients ultrasound was abnormal. VCUG was abnormal in 25 patients. Conclusions: Anorectal malformations occurred equally in males and females. Females had intermediate defects more frequently, rectovestibular fistula being the commonest. Males were more likely to have high lesions; anorectal agenesis without fistula was the commonest defect. The most common associated defects seen were vesicoureteric reflux and esophageal atresia. Complications were seen more commonly in males with high lesions. There was a significant association between presence of an associated defect and mortality and morbidity.