Spanish Version
 
E-mail Form
Email Results

 
 
Print-Friendly
Bookmarks
bookmarks-menu

Imperforate anus

Anorectal malformation; Anal atresia

Imperforate anus is a defect in which the opening to the anus is missing or blocked. The anus is the opening to the rectum through which stools leave the body. This is present from birth (congenital).

Causes

Imperforate anus may occur in several forms:

  • The rectum may end in a pouch that does not connect with the colon.
  • The rectum may have openings to other structures. These may include the urethra, bladder, base of the penis or scrotum in boys, or vagina in girls.
  • There may be narrowing (stenosis) of the anus or no anus.

It is caused by abnormal development of the fetus. Many forms of imperforate anus occur with other birth defects.

Symptoms

Symptoms of the problem may include:

  • Anal opening very near the vagina opening in girls
  • First stool is not passed within 24 to 48 hours after birth
  • Missing or moved opening to the anus
  • Stool passes out of the vagina, base of penis, scrotum, or urethra
  • Swollen belly area

Treatment

A health care provider can diagnose this condition during a physical exam. Imaging tests may be ordered.

The infant should be checked for other problems, such as abnormalities of the genitals, urinary tract, and spine.

Surgery to correct the defect is needed. If the rectum connects with other organs, these organs will also need to be repaired. A temporary colostomy (connecting the end of the large intestine to the abdomen wall so that stool can be collected in a bag) is often needed.

Outlook (prognosis)

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

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

Some children may need more surgery.

When to Contact a Medical Professional

This problem is often found when the newborn infant is first examined.

Call your provider if a child treated for imperforate anus has:

  • Abdominal pain
  • Constipation that is difficult to manage
  • Failure to develop any bowel control by the age of 3

Prevention

There is no known prevention. Parents with a family history of this defect may seek genetic counseling.

References

Dingelsein M. Selected gastrointestinal anomalies in the neonate. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 84.

Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Surgical conditions of the anus and rectum. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 371.

  • Imperforate anus

    Imperforate anus - illustration

    Imperforate anus is a malformation of the anorectal region that may occur in several forms. The rectum may end in a blind pouch that does not connect with the colon, or it may have openings to the urethra, bladder, or vagina. A condition of stenosis, or narrowing of the anus, or absence of the anus may be present.

    Imperforate anus

    illustration

  • Imperforate anus repair - series

    Imperforate anus repair - series

    Presentation

    • Imperforate anus

      Imperforate anus - illustration

      Imperforate anus is a malformation of the anorectal region that may occur in several forms. The rectum may end in a blind pouch that does not connect with the colon, or it may have openings to the urethra, bladder, or vagina. A condition of stenosis, or narrowing of the anus, or absence of the anus may be present.

      Imperforate anus

      illustration

    • Imperforate anus repair - series

      Presentation

     

    Review Date: 4/4/2019

    Reviewed By: Liora C. Adler, MD, Pediatric Emergency Medicine, Joe DiMaggio Children's Hospital, Hollywood, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

    The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
    adam.com

     
     
     

     

     

    A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.
    Content is best viewed in IE9 or above, Firefox and Google Chrome browser.