The decision to open a colostomy is usually taken within the first 24 hours of birth.Sonography can be used to determine the type of imperforate anus. Treatment
Imperforate anus usually requires immediate surgery to open a passage for feces unless a fistula can be relied on until corrective surgery takes place. Depending on the severity of the imperforate, it is treated either with a perineal anoplasty or with a colostomy. While many surgical techniques to definitively repair anorectal malformations have been described, the posterior sagittal approach (PSARP) has become the most popular. It involves dissection of the perineum without entry into the abdomen and 90% of defects in boys can be repaired this way. Prognosis
With a high lesion, many children have problems controlling bowel function and most also become constipated. With a low lesion, children generally have good bowel control, but they may still become constipated. For children who have a poor outcome for continence and constipation from the initial surgery, further surgery to better establish the angle between the anus and the rectum may improve continence and, for those with a large rectum, surgery to remove that dilated segment may significantly improve the bowel control for the patient. An antegrade enema mechanism can be established by joining the appendix to the skin (Malone stoma); however, establishing more normal anatomy is the priority. Epidemiology
Imperforate anus has an estimated incidence of 1 in 5000 births. It affects boys and girls with similar frequency.
However, imperforate anus will present as the low version 90% of the time in females and 50% of the time in males. Imperforate anus is an occasional complication of sacrococcygeal teratoma. Society and culture
Ribbon
The ribbon to represent anorectal malformations/imperforate anus abnormalities is turquoise, which encapsulates hope, strength and a positive attitude. Zebra stripes were added to show the uniqueness and represent just how no two zebra markings are the same, nor are people living with ARM/IA. Awareness day
The international awareness day for anorectal abnormalities is 1 May. The day aims to raise awareness about an abnormality many have not heard of by creating a human connection for an abnormality that often leaves people feeling alone. The day 1 May was chosen to represent the incidence of such malformations, which occur in roughly 1 in 5,000 babies. History
Seventh-century Byzantine physician Paulus Aegineta described a surgical treatment for imperforate anus for the first time. tenth-century Persian physician Haly Abbas was the first to highlight preserving the sphincter muscles throughout the surgery and the prevention of strictures with a stent. He has reported the use of wine for wound care in this surgery. Some reports of children surviving this surgery are available from the early medieval Islamic era. References
External links
Medline Plus Medical Encyclopedia: Imperforate anus