Anorectal malformation (ARM), commonly known as imperforate anus or absent anal opening, is a congenital defect that occurs during fetal development. In this condition, the baby's rectum and anal passage do not form properly, which leads to difficulty or inability in passing stool. This defect affects approximately 1 in every 5,000 live births and is slightly more common in male infants compared to females.

As the leading cause of lower intestinal blockage in newborns, Anorectal Malformation in India remains a critical condition requiring timely diagnosis and expert surgical intervention.

What Happens in Anorectal Malformation?

In Infants with ARM, the Following Abnormalities May be Present:

-The anal opening is absent entirely or located incorrectly.
-The rectum may connect to other structures like the urethra (urinary passage), bladder, or vagina, causing stool to pass through unusual routes or resulting in serious infections.
-In some severe cases, the baby may have a cloaca—a single opening where the rectum, urinary tract, and reproductive tract merge, a complex defect needing specialized care.

These defects can lead to severe complications such as bowel obstruction, infection, and problems with urination and stool control if left untreated.

Diagnosis of Anorectal Malformation:

Newborns are carefully examined immediately after birth to detect any signs of ARM. Normally, babies pass their first stool (meconium) within 24 to 48 hours. If this does not occur, or if the anal opening seems abnormal, further tests are initiated.

Diagnostic Evaluations Include:

-Abdominal X-ray: To determine the location of the rectal pouch and detect other abdominal abnormalities.
-Abdominal Ultrasound: To assess kidney development and urinary tract health, as urinary system defects may coexist.
-Spinal Ultrasound/MRI: To detect spinal cord abnormalities such as tethered cord, which can impact lower body nerve function.
-Echocardiogram: To screen for associated congenital heart defects.

Since ARM can also be part of VACTERL association (a syndrome involving vertebral, anal, cardiac, tracheoesophageal, renal, and limb anomalies), a thorough screening is crucial.

Treatment of Anorectal Malformation:

Surgical correction is the cornerstone of ARM treatment and should be performed by an expert pediatric surgeon or the Best Pediatric Urologist in Delhi for optimal results. The approach depends on the severity and type of malformation:

1. Single-Stage Repair: For simple malformations, surgery may be performed soon after birth to create a proper anal opening.
2. Multi-Stage Repair: Complex cases may require an initial colostomy (temporary stoma on the abdominal wall) to divert stool, followed by definitive repair surgery after a few months.
3. Cloacal Repair: Babies with cloacal malformations undergo staged procedures to separately reconstruct the rectum, urinary tract, and reproductive tract.

The Goals of Surgery are:

-To allow the baby to pass stool normally.
-To protect urinary and reproductive organs from damage or infection.
-To achieve good long-term bowel control.

Long-Term Bowel Management and Care:

Even after successful surgery, some children may have weak or absent nerve and muscle function in the pelvic area. These nerves help the child sense a full rectum and control bowel movements. Therefore, a bowel management program becomes essential when the child reaches toilet-training age.

This Program Includes:

-Scheduled toilet sitting.
-Use of laxatives or enemas to empty the bowel regularly.
-Diet adjustments to maintain soft stool consistency.
-Physiotherapy or pelvic floor exercises as needed.

Early bowel training enhances the chances of achieving social continence—where the child can avoid accidents and lead a normal school and social life.

Why Choose the Best Pediatric Urologist in Delhi?

For families seeking treatment for Anorectal Malformation in India, consulting the Best Pediatric Urologist in Delhi ensures your child receives comprehensive, expert care. These specialists provide:

-Accurate diagnosis using state-of-the-art imaging.
-Individualized surgical plans for each child’s unique anatomy.
-Expertise in managing complex cases, including cloacal malformations.
-Dedicated long-term follow-up for bowel and urinary management.

With the right surgical team and post-operative support, most children born with ARM can grow up to lead healthy, active lives. Please visit: https://www.pedsurgerydelhi.com/diseases/anorectal-malformation-in-india-absent-anal-opening-treatment-in-delhi/

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