Access to essential paediatric surgery in the developing world: a case of imperforate anus with rectovaginal and rectocutaneous fistulas left untreated.
Anorectal malformations consist of a wide spectrum of conditions which can affect both sexes and involve the distal anus and rectum as well as the urinary and genital tracts. Patients have the best chance of a good functional outcome if the condition is diagnosed early and efficient anatomic repair is promptly instituted. This report describes a rare case of imperforate anus associated with both rectovaginal and rectocutaneous fistulas in a 6-year-old Filipino girl. The case highlights shortcomings in the healthcare delivery system combined with socio-economic factors that contributed to the delay in both diagnosis and the institution of adequate treatment. Care and preventive measures that can be implemented in low-resource settings to reduce the impact of birth defects are also discussed.
Department of Health, RITM, Manila, Philippines.
Marilyn L
ML
Vinluan
Department of Health, RITM, Manila, Philippines.
Remigio M
RM
Olveda
University of the East-Ramon Magsaysay Memorial Medical Center, The Philippines.
Clive K
CK
Ortanez
University of the East-Ramon Magsaysay Memorial Medical Center, The Philippines.
Modesto
M
Abellera
University of the East-Ramon Magsaysay Memorial Medical Center, The Philippines.
David U
DU
Olveda
Department of Health, Northern Samar, The Philippines.
Delia C
DC
Chy
Griffith Health Institute, Southport, Queensland, Australia.
Allen G
AG
Ross
D001003:Anal Canal / Q000002:abnormalities* / Q000601:surgery*; D000071056:Anorectal Malformations; D001006:Anus, Imperforate / Q000175:diagnosis* / Q000601:surgery*; D002648:Child; D000013:Congenital Abnormalities / Q000601:surgery*; D003906:Developing Countries; D005260:Female; D014943:Global Health; D006297:Health Services Accessibility; D006801:Humans; D010679:Philippines; D012006:Rectovaginal Fistula / Q000150:complications / Q000601:surgery*; D012007:Rectum / Q000002:abnormalities* / Q000601:surgery