title: Association of anorectal malformation and intestinal malrotation.
abstract: BACKGROUND
  Patients born with anorectal malformations (ARM) frequently have other congenital anomalies that are well-defined; however, limited data exist examining the relationship of ARM with malrotation.
  
  
  METHODS
  A 10-year retrospective review was performed to examine all patients treated at a regional children's medical center with a diagnosis of ARM. Data were collected to identify malrotation, vertebral, anorectal, cardiac, tracheo-esophageal fistula, renal, radial, limb (VACTERL) anomalies, the type of ARM, operative procedures performed, and long-term bowel management.
  
  
  RESULTS
  One hundred forty-six patients were identified. Upper gastrointestinal evaluation was performed in 21 patients (14.4%), while contrast enemas were performed in 22 patients (15.1%). Seven patients were found to have malrotation (4.8%) and 6/7 of these patients had 2 or more VACTERL anomalies.
  
  
  CONCLUSIONS
  Patients with ARM and 2 or more VACTERL anomalies should undergo screening for malrotation. Patients with intestinal malrotation, ARM, and poor potential for bowel control should have their appendix preserved during a Ladd's procedure.
authors.affiliation: Madigan Army Medical Center, Department of General Surgery, Fort Lewis, WA 98431, USA.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Chesley
authors.affiliation: Division of Pediatric General and Thoracic Surgery, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, USA; University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: Lilah
authors.initials: L
authors.lastname: Melzer
authors.affiliation: Division of Pediatric General and Thoracic Surgery, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, USA; University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: Miranda C
authors.initials: MC
authors.lastname: Bradford
authors.affiliation: Division of Pediatric General and Thoracic Surgery, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, USA; University of Washington School of Medicine, Seattle, WA, USA. Electronic address: Jeffrey.avansino@seattlechildrens.org.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Avansino
mesh_terms: D000071056:Anorectal Malformations; D001006:Anus, Imperforate / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D045822:Intestinal Volvulus / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D014861:Washington / Q000453:epidemiology
keywords: Anorectal malformation; Antegrade continence enema; Appendicostomy; Intestinal malrotation