Anorectal Malformation Treatment, Denver

Anorectal Malformation describes several types of birth defects that affect the anus (the opening at the end of the intestine through which stool leaves the body) and the rectum (the area of large intestine just above the anus). Rocky Mountain Hospital for Children is uniquely equipped to diagnose and treat such conditions. Our team of neonatologists, pediatric surgeons and highly educated staff are specially trained to care for babies affected by anorectal malformation. In addition, our facility is specifically designed to care for babies and children so that your baby will receive the most appropriate and safe care possible.

About Anorectal Malformation

An estimated 1 in 5,000 babies are born with an anorectal malformation. The anus and rectum form between weeks five and seven of gestation. For unknown reasons, some babies do not develop this area correctly. Abnormalities can include:

  • Narrow Anal Passage
    • Patient experiences constipation and discomfort
  • Anal Membrane: A thin membrane covers the anus, blocking stool
    • Patient is unable to pass stool
  • Imperforate Anus: The rectum is not connected to the anus
    • Patient is unable to pass stool
  • Imperforate Anus with Fistula: The rectum is connected to part of the urinary tract or reproductive system with a fistula (a thin tube)
    • Patient passes stool through the fistula instead of anus leading to complications such as infection

Babies with anorectal malformations often have other abnormalities as well. This condition is linked to a group of other conditions that often appear together, called VACTERL:

  • Vertebral
  • Anorectal Malformation
  • Cardiac
  • Tracheoesophageal Fistula/Esophageal Atresia
  • Renal or kidney
  • Limb

Anorectal Malformation Diagnosis

After birth, your pediatrician will perform a thorough physical exam. During this exam, the physician looks at the anus to see if it is open and in the correct place.  If an abnormality is seen during this exam or is seen in the way stool is passed (or not passed at all), additional testing may include an abdominal X-Ray and abdominal ultrasound to determine the exact details of your baby’s condition.

Anorectal Malformation Treatment

Treatment for anorectal malformation is determined by the type of defect, the extent of the abnormality and other existing health conditions. Babies affected by a narrow anal passage often do not require surgical intervention and can be treated with a procedure called anal dilation. Babies affected by an anal membrane will undergo surgery to have the membrane removed. Some of these patients also may require anal dilation to help ensure free passage of stool.

Babies with imperforate anus (with or without a fistula) require surgery to correct the condition. Typically, surgery takes place in several stages. First, a colostomy is performed. This procedure splits the large intestine and routes the ends through openings in the abdominal wall (called stoma). Stool leaves the body through the top part of the intestine and is collected in a bag outside the body. Intestinal mucous is collected from the lower section. This allows the affected area to grow, clean of stool, to enhance outcomes and reduce infection during the second stage of the operation. A few months after the colostomy, a second surgery is performed to attach the rectum to the anus. The colostomy is left intact to continue protecting the area from infection. A final surgery is performed several months later during which the colostomy is closed. The pediatric surgeons at Rocky Mountain Pediatric Surgery  offer advanced minimally invasive techniques for babies with imperforate anus. This type of surgery is designed to reduce the impact of the procedure on the baby’s body. It utilizes smaller incisions, which lessens pain and shortens healing time.

Long-Term Outlook for Anorectal Malformation

Babies with anorectal malformations sometimes require long-term follow up care, including bowel management programs. The team at Rocky Mountain Hospital for Children will work with your child to help create a program that is tailored to his/her specific needs.

To find an expert pediatrician or pediatric surgeon, contact our program care coordinator at 720-754-4902.