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Imperforate anus repair

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

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.

Presentation

Imperforate anus repair - series

Description

How this surgery is performed depends on the type of imperforate anus. The surgery is done under general anesthesia. This means the infant is asleep and feels no pain during the procedure.

For mild imperforate anus defects:

Two surgeries are often needed for more severe imperforate anus defects:

Your child's surgeon can tell you more about the exact way the surgeries will be done.

Why the Procedure Is Performed

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

Risks

Risks from anesthesia and surgery in general include:

Risks of this procedure include:

Before the Procedure

Follow instructions on how to prepare your baby for the surgery.

After the Procedure

Your baby may be able to go home later the same day if a mild defect is repaired. Or, your baby will need to spend several days in the hospital.

The health care provider will use an instrument to stretch (dilate) the new anus. This is done to improve muscle tone and prevent narrowing. This stretching must be done for several months.

Outlook (Prognosis)

Most defects can be corrected with surgery. Children with mild defects usually do very well. But, constipation may be a problem.

Children who have more complex surgeries still usually have control of their bowel movements. But, 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. 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, legs, or spine.

Related Information

Imperforate anus
Fistula
Colostomy

References

Bischoff A, De La Torre L, Peña A. Imperforate anus. In: Wyllie R, Hyams JS, Kay M, eds. Pediatric Gastrointestinal and Liver Disease. 6th ed. Philadelphia, PA: Elsevier; 2021:chap 55.

Shanti CM. 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.

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Review Date: 9/19/2021  

Reviewed By: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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