Expert Opinion :
This child has one birth defect – an imperforate anus. Other birth defects that can occur with the imperforate anus are cardiovascular malformations (12-22%); tracheoesophageal abnormalities (10%); gastrointestinal defects such as duodenal obstruction due to annular pancreas or duodenal atresia, malrotation with Ladd bands, Hirschsprung disease, constipation; spinal dysraphism (17-46%); urologic abnormalities such as hydronephrosis and vaginal and uterine abnormalities. Hence the child should undergo an ultrasound of the abdomen & pelvis and echocardiographic examination.