Imperforate anus repair

 

Alternative Names

Anorectal malformation repair; Perineal anoplasty; Anorectal anomaly; Anorectal plasty

Definition

Imperforate anus repair is surgery to correct a birth defect involving the rectum and anus.

An imperforate anus defect prevents most or all stool from passing out of the rectum. 

Why the Procedure Is Performed

The surgery repairs the defect so that stool can move through the rectum.

Risks

Risks from any anesthesia include:

  • Reactions to medications
  • Problems breathing

Risks from any surgery include:

  • Bleeding
  • Infection

Risk from this procedure include:

  • Damage to the urethra (tube that carries urine out of the bladder)
  • Damage to the ureter (tube that carries urine from the kidneys to the bladder)
  • Hole that develops through the wall of the intestine
  • Abnormal connection (fistula) between the anus and vagina or skin
  • Narrowed opening of the anus
  • Long-term problems with bowel movements because of damage to the nerves and muscles to the colon and rectum (may be constipation or incontinence)
  • Temporary functional paralysis of the bowel (paralytic ileus)

After the Procedure

The infant may be able to go home later the same day if a mild defect is repaired. Or, the child may spend several days in the hospital.

The health care provider will use an instrument to stretch (dilate) the new anus to improve muscle tone and prevent narrowing. This stretching must be done for several months. Stool softeners and a high-fiber diet are recommended throughout childhood.

Outlook (Prognosis)

Most defects can be corrected with surgery. Most children with mild defects do very well. However, constipation may be a problem.

Children who have more complex surgeries still usually have control of their bowel movements. However, they often need to follow a bowel program, which includes eating high-fiber foods, taking stool softeners, and sometimes using enemas.

Some children may need more surgery. Most of these children will need to be followed-up closely for life.

Children with imperforate anus may also have other birth defects, including problems with the heart, kidneys, arms or legs, or spine.

References

Warner BW. Pediatric surgery. In: Townsend CM, Beauchamp RD, Eyers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 71.

Stafford SJ, Klein MD. Anus and rectum. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 336.

Review Date: 10/18/2013
Reviewed By: John A. Daller, MD, PhD., Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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