Imperforate anus (anal agenesis) with rectal and sigmoid atresias in a newborn.
A male baby was born to a healthy mother after an uncomplicated 39-week pregnancy. He had finger and toe syndactyly, right hemidiaphragm eventration, and a high imperforate anus (anal agenesis). The kidneys and chromosomes were normal. A right transverse colostomy was done and 5 months later he underwent a posterior sagittal anorectoplasty (Pena procedure). An intermediate imperforate anus with no urethral fistula and a rectal atresia 2 cm proximal to the distal rectal pouch were found; the distal rectal pouch was resected and the standard Pena procedure completed. Dilatations were initiated 2 weeks postoperatively and continued until the colostomy was closed. Prior to closure of the colostomy, a distal colon loopogram demonstrated an obstruction in the sigmoid; constrast introduced via the rectum outlined the same obstruction separated by 2 cm. A low sigmoid atresia was then repaired. Three weeks later, a contrast loopogram showed a narrow but intact rectosigmoid anastomois, and the colostomy was closed. The anorectal dilatations were discontinued and he remains well at 7 years of age.
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Division of General Surgery, Hospital for Sick Children, Toronto, Ontario, Canada, M5G 1X8.
D000015:Abnormalities, Multiple / Q000601:surgery; D001006:Anus, Imperforate / Q000150:complications* / Q000601:surgery; D012809:Colon, Sigmoid / Q000002:abnormalities* / Q000601:surgery; D003125:Colostomy; D003965:Diaphragmatic Eventration / Q000150:complications; D004106:Dilatation; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D012007:Rectum / Q000002:abnormalities* / Q000601:surgery