Anal Atresia Overview & Definition

Anal atresia is a birth defect which affects the gastroinstestinal tract. Anal atresia/stenosis occurs when an infant is born without an anus, or the anus or rectum is blocked or closed. This congenital defect prevents most or all of an infant’s stool from exiting the rectum. Alternate names for anal atresia include congenital imperforate anus and anorectal malformation. Anal atresia is diagnosed very soon after birth when the infant undergoes a physical examination.

Anal Atresia Symptoms

  • No anal opening, or anal opening is in wrong   location
  • Infant does not pass the first stool within   the first 25-48 hours of life
  • Stool is being secreted though the vagina,   penis, scrotum or urethra
  • Stomach is tight and swollen
  • Child does not have bowel control by age   three

Types of Anal Atresia

Anal atresia can occur in different forms. It is important to determine the position and type of imperforated anus in order to implement the correct treatment. The following are types of anal atresia:

  • Low imperforate anus/low lesion:  A low lesion occurs when the colon remains close to the skin. This may lead to anal stenosis, which is a narrowing of the rectum or anus. A low lesion could also lead to the absence of the anus altogether. In this case the rectum ends in a blind pouch that does not connect with the colon.
  • High imperforate anus/high lesion: In a high lesion, the colon is higher up in the body and a fistula connects the rectum and the bladder, urethra or the vagina.
  • Persistent cloaca:  A persistent cloaca occurs when an infant is born with the rectum, vagina and urinary tract as a single common channel. Only females are born with this malformation.
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Anal Atresia Treatment

Anal atresia requires immediate surgery in order to make a clear passage for stool. Imperforate anus surgery depends on the form and severity of the lesion. A low lesion is normally repaired very early in life by a procedure called the perineal anoplasty. In a high imperforate anus a colostomy is performed almost immediately after diagnosis. A colostomy is a temporary opening in the large intestine where waste can be excreted. The colostomy remains for several months, letting the baby grow, until a new anus can be surgically made.

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Anal Atresia Prognosis

Prognosis is usually good once the anal atresia is treated. In severe cases with high lesion, however, a child may never gain complete control of his or her bowel movements. Some children may also suffer from constipation.

Anal Atresia Complications

  • Bowel incontinence
  • Constipation
  • Intestinal blockage

Anal Atresia Cause

The exact cause of this congenital defect is not known. Research has linked other congenital malformations to the use of antidepressants during pregnancy. Baum Hedlund is investigating a possible link between the use of antidepressants in pregnancy and the risk of imperforate anus at birth.
http://www.dshs.state.tx.us/birthdefects/risk/risk12-anal_atr.shtm