title: One hundred three consecutive patients with anorectal malformations and their associated anomalies.
abstract: OBJECTIVE
  A long-term retrospective analysis of 103 infants with anorectal malformations (ARMs) was conducted to describe any associated congenital anomalies and surgical classifications.
  
  
  METHODS
  Retrospective medical record review.
  
  
  METHODS
  This case series was conducted on all infants with ARMs born at, or referred to, any of 3 major medical centers in Wichita, Kan, for close to a 22-year period.
  
  
  METHODS
  The 103 infants in this study represent a consecutive sample of patients with ARMs. Patients were separated into 2 groups: isolated ARMs without associated anomalies (n = 30), and ARMs with associated anomalies (n = 73). The male-female ratio was 2:1.
  
  
  METHODS
  Patients with associated anomalies were further classified into groups of ARMs with minor anomalies; major anomalies; chromosomal abnormalities; and malformation syndromes, associations, or sequences. Only anomalies that occurred more than once were reported. Malformations were also classified according to major organ systems.
  
  
  RESULTS
  The incidence of ARMs in our study was approximately 1 in 2500 live births. Additional anomalies were found in 71% of infants with ARMs. Associated anomalies by major organ system included genitourinary anomalies (49%), musculoskeletal anomalies (43%), craniofacial anomalies (34%), cardiovascular anomalies (27%), gastrointestinal anomalies (18%), respiratory anomalies (13%), and central nervous system anomalies (12%). The most common chromosomal abnormalities were trisomies (8%), and ARMs were associated with VATER complex (vertebral defects, anal atresia, tracheoesophageal fistula with esophageal atresia, and radial and renal anomalies) in 11 cases (11%) and VACTERL (vertebral, anal, cardiac, tracheal, esophageal, renal, and limb anomalies) in 4 cases (4%).
  
  
  CONCLUSIONS
  Patients with ARMs have a high incidence of associated congenital anomalies. Evaluation of the most commonly affected organ systems in these infants is essential because it is these associated anomalies that account for most of the morbidity and mortality that is associated with this condition.
authors.affiliation: Department of Pediatrics, Kansas University School of Medicine-Wichita, 1010 N Kansas St, Wichita, KS 67214, USA. sechincho@compuserve.com
authors.forename: S
authors.initials: S
authors.lastname: Cho
authors.forename: S P
authors.initials: SP
authors.lastname: Moore
authors.forename: T
authors.initials: T
authors.lastname: Fangman
mesh_terms: D000015:Abnormalities, Multiple / Q000453:epidemiology* / Q000235:genetics; D000293:Adolescent; D000328:Adult; D001003:Anal Canal / Q000002:abnormalities*; D002869:Chromosome Aberrations / Q000453:epidemiology; D025063:Chromosome Disorders; D000013:Congenital Abnormalities / Q000145:classification / Q000453:epidemiology / Q000235:genetics; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007615:Kansas / Q000453:epidemiology; D008297:Male; D008423:Maternal Age; D012007:Rectum / Q000002:abnormalities*; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution