Growth Charts
Possible Newborn Health Problems
Heart Defects
Gastro-intestinal Tract Disorders
Duodenal Atresia
Hirschsprung's Disease
Imperforate Anus
Tracheo-oesophageal Fistula
Congenital Cataracts
Unusual Blood Results

Imperforate Anus

Imperforate anus occurs when there is growth of skin over the anus and faeces cannot pass in the usual way. Imperforate anus consists of

Incomplete development of the rectum;
the rectum ends too soon, either

• Just before the anus, among the pelvic nerve and muscle structures ("low type" imperforate anus) or

• Above the pelvic nerve and muscle structures ("high type" imperforate anus)

Unusual anal opening
either

• no anal opening so no faeces can pass, or

• a very small fistula (channel) from the bowel to the skin, vagina or urethra so a small amount of faeces can pass in an unusual way

Sometimes associated problems in other parts of the body, especially the urinary tract.

With a high type imperforate anus, over half of babies will also have a urinary tract problem, this is not so common with a low type imperforate anus.

Usually imperforate anus is found immediately after birth when the lack of an anal opening is noticed.

Babies with imperforate anus need
• a drip

• a tube into the stomach

• a heart echo

• to be in a paediatric surgery centre

An x-ray and ultra-sound of the abdomen to show whether it is a high or low lesion and whether there are any problems with the urinary tract or spinal cord.

Surgery for imperforate anus is always needed within the newborn period.
Surgery for the low type imperforate anus, involves one operation which

• closes any fistula,

• creates an anal opening, and

• joins the rectum to the anal opening.

Surgery for a high type imperforate anus defect usually involves two or three operations;

• creates a temporary colostomy; the colon is brought out to the surface of the abdomen so that faeces can be expelled.

The baby is allowed to grow for several months

• anal repair with a pull-through operation
- creates an anal opening, and
- joins the rectum to the anal opening; the rectum is "pulled down"
- colostomy may be closed

• colostomy is closed if not closed in second operation

After the operation, the baby will need a few days in the neo-natal intensive care unit, then a few weeks in hospital until feeding is going well and there are no other problems.

Further operations will be in the paediatric department of the hospital.

After surgery the child will continue to have check-ups with the paediatric surgeon to check that the child has no intestinal problems and when older to check the child is gaining good bowel control