Ectopic Anus
Jagdish Kathwate
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Ectopic Anus - Patient Education
What is Ectopic anus?
Anorectal malformation is a term used to describe several types of anomalies. The anus and the rectum (which is the part of bowel immediately above the anus) have not developed properly.
• No anal (bottom) opening at all
• An ectopic anus (small opening in the wrong place)
• Anal stenosis (narrowed opening of the bottom)
We usually classify them as “high” or “low” anomalies depending on the gap between the bowel and the skin.

Why does it occur?
We are unclear as to why it occurs but we do know that sometimes the process of development in the womb is not complete. This is not due to anything that you have done or not done during your pregnancy. It is a rare problem that affects slightly more boys than girls (around 1 in 5000 babies).

Will my baby have any other problems?
Most babies will have otherwise of developed normally. However there can be other problems with the development of other systems such as the kidneys, heart, spine and oesophagus (VATER syndrome).

How are anorectal malformations diagnosed?
It is usually obvious following delivery that the anus is not present or in the wrong place. Sometimes the problem is not immediately apparent and the baby is fed as usual. If this is the case your baby may vomit and the abdomen (tummy) may become progressively distended (bigger).If the anus is stenosed there may be a delay in passing meconium that happens normally within the first 24 hours following delivery. If there is a fistula present, meconium may be present in the urine or, in girls, come out through the vagina.

What is the treatment?
Feeds, if started, will be stopped and a nasogastric tube (a tube through the nose down to the stomach) will be passed. This enables us to keep the stomach empty so the baby does not vomit and your baby will be given fluid through a drip sited in one of its veins. An X-ray will be taken after 24 hours of age (this allows time for swallowed air to travel through the bowel) to determine whether the anomaly is:
• 'Low' - if the bowel is present just under the skin
• 'High' - if the bowel ends up higher within the baby’s tummy
Treatment will vary depending on the classification but usually an operation will be necessary. All babies will need a small dose of antibiotics to prevent urine infections because of the possibility of a fistula or an associated problem in the urinary tract. This will need to continue for at least several months.


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