Congenital malformations of anus and rectum

摘要: Abstract One hundred sixty-two cases of anal and rectal abnormalities were reported from the Boston Children's Hospital. The embryology anorectal region is reviewed. malformations under discussion are believed to represent arrests or aberrations in development anus rectum seventh eighth week fetal life. classified into four groups which had following characteristics: (1) Stenosis anus; (2) membranous obstruction (3) imperforate anus, but with separation (4) canal normal, pouch. external sphincter muscle was present all types. Associated these obstructions there fistulae 52 per cent patients, connecting bladder, urethra, vagina, fossa navicularis, perineum. symptoms physical signs essentially those acute bowel when an atresia rectum. In stenosis instances a large associated fistula, less evidence intestinal obstruction. Fistulae urinary tract manifested by presence infection passage fecal material flatus through urethra. X-ray examination valuable aid determining distal extent pouch atresia. This could be readily accomplished taking flat plate baby inverted position, thus allowing gas outline Due fact that some time required for reach lower tract, method not wholly reliable first fifteen twenty hours essential treatment establish continuity epithelium between skin prevent scar formation constriction. To provide adequate control, always employed. stenoses (Type 1) repeated dilatations usually necessary, unyielding, it excised mucosa brought down cover defect. 2) simple cruciate incision sufficed. atresias (Types 3 4) treated perineal operation (when low enough) muscle. When high prohibited successful operation, colostomy resorted to. Type 86 amenable approach. 4 atresias, 66 operation. There 43 deaths series, giving mortality 26 cent. At least 12 directly due other congenital abnormalities, leaving expected rate about 19 their complications. By rates were: 1, 9.5 cent; 2, 16.6 3, 24.8 4, 61.6 (rectoperineal, rectofossa rectovaginal) relatively easy close corrected few days higher (rectourethral rectovesical), however, very difficult newborn infant, hence found best delay such communications until patient attained age eight nine years.