Surgical management of perineal masses in patients with anorectal malformations

Shaul, Donald B.; Monforte, Hector; Levitt, Marc A.; Hong, Andrew R.; Peña, Alberto

doi:10.1016/j.jpedsurg.2004.09.027

Cited by 29 publications

(36 citation statements)

References 7 publications

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“…Five publications reported perineal lipoma with ARM (Table 1). [1][2][3][4][5] Seven reports were excluded from analysis because they involved other diseases. On review of the literature, 21 patients (including the present two) with perineal lipoma and ARM were identified (Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…Aside from perineal lipoma with ARM, other perineal masses, identified on pathology, with ARM consisted of hemangioma, lymphaticovenous malformation, hamartoma, choristoma and ectopic scrotal tissue. 1 The exact relationship between perineal lipoma and ARM remains obscure. Between the 10th and 12th week of gestation, the labioscrotal folds migrate to the medial region.…”

Section: Discussionmentioning

confidence: 99%

“…If the lipoma is large with infiltration into the sphincter muscle, it should be removed during anorectoplasty while taking care to preserve the muscle fibers. 1,3 In patient 1, excision of the mass and ASARP were performed with another skin incision. In contrast, in patient 2, excision of the mass and ASARP were performed with the same skin incision.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Perineal lipoma with anorectal malformation: Report of two cases and review of the literature

Hashizume

Asagiri

Fukahori

et al. 2017

Pediatrics International

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Perineal lipoma with anorectal malformation: Report of two cases and review of the literature

Hashizume

Asagiri

Fukahori

et al. 2017

Pediatrics International

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“…These latter ones were simply excised and did not seem to have an etiologic relation with the malformation. 9 Management involves preoperative bowel preparation and elliptical incision to visualize the lipomatous swelling. Carefully it should be dissected away from the perianal fat and relentlessly attempting to save the anal sphincters if they are involved.…”

Section: Discussionmentioning

confidence: 99%

Pedunculated perianal lipoma: a rare presentation

et al. 2015

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“…In humans, imperforate anus or other anorectal malformations have been associated with perineal masses, including lipomas, hamartomas, choristomas, and vascular anomalies such as hemangiomas or lymphaticovenous malformations. 9 One choristoma in a study of perineal masses in 22 patients with anorectal malformation 9 was in a female infant and included nephrogenic rests like those in calf No. 1.…”

Section: Discussionmentioning

confidence: 99%

Perineal Choristoma and Atresia Ani in 2 Female Holstein Friesian Calves

et al. 2012

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Atresia ani, a congenital anomaly of the anus, can be associated with other types of malformation. Two female Holstein Friesian calves had imperforate anus, rectovaginal fistula, and perineal choristomas. In one case, the choristoma was composed of mature adipose and fibrous tissue with nephrogenic rests. In the other calf, the choristoma consisted of fragments of trabecular bone coated by cartilage and containing marrow, mixed with mature adipose and fibrous tissue, striated muscle fibers, nerves, and vessels. This combination of malformations resembles the association of anorectal malformations and perineal masses in children.Keywords atresia ani, cattle diseases, choristoma, congenital defects, perineal mass Atresia ani is the most common congenital defect of the lower gastrointestinal tract in mammals and is reported mainly in ruminants and pigs. The defect may consist of a failure of perforation of the fetal anal membrane that separates the endodermal hindgut from the ectodermal part of the anus, or both rectum and anus may be absent.2 Atresia ani is classified into 4 types. Type 1 is characterized by a normal rectum and a patent but stenotic anus. In type 2 atresia ani, or imperforate anus, the rectum ends in a blind pouch without development of the anus. Type 3 is an imperforate anus associated with a blind pouch in the orad part of the rectum. Type 4 is characterized by atresia of the orad rectum with normal development of terminal rectum and anus. A case of atresia ani associated with fibrolipomatous hamartoma has also been reported in a calf. 10 In the current report, a choristoma was associated with type II atresia ani in 2 calves. Case DescriptionsCase No. 1A 5-day-old female Holstein Friesian calf had a 4-day history of abdominal pain and anorexia. Type 2 atresia ani (imperforate anus), a rectovaginal fistula of 1-cm diameter, a 4-cm-diameter reducible umbilical hernia, and a perineal mass were diagnosed upon physical examination. The ulcerated, sessile perineal mass (20 Â 15 Â 15 cm) was to the right of the vulva (Fig. 1). The atresia ani, the rectovaginal fistula, and the umbilical hernia were surgically corrected; the perineal mass was excised. The calf was discharged 11 days after surgery. Case No. 2A 1-day-old female Holstein Friesian calf with imperforate anus had an ulcerated, pedunculated mass (5 cm in diameter) that protruded from the right perineum 5 cm ventral to the tailhead (Fig. 2). Feces leaked from the vagina due to the presence of a 0.5-cmlong rectovaginal fistula. The atresia ani and the rectovaginal fistula were surgically corrected; the perineal mass was excised. Ten days after surgery, the calf developed cyanosis, coughing, and a heart murmur. It died on postsurgery day 11. At necropsy, cardiac ventricular and atrial septal defects with pulmonary edema were observed. No gross abnormalities were detected in other organs.

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Surgical management of perineal masses in patients with anorectal malformations

Cited by 29 publications

References 7 publications

Perineal lipoma with anorectal malformation: Report of two cases and review of the literature

Perineal lipoma with anorectal malformation: Report of two cases and review of the literature

Pedunculated perianal lipoma: a rare presentation

Perineal Choristoma and Atresia Ani in 2 Female Holstein Friesian Calves

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