Recently, when sorting out the problems of anorectal diseases, we found that many users asked about the causes and treatment of anal atresia, so we will briefly talk about congenital anal atresia today.
Congenital anal atresia, also known as anus locking and anuslessness, is a condition in which the anus, anal canal, and lower rectum are atretic after birth and the anus is not visible from the outside.
Causes
In the early embryonic stage, the anus and rectum are not separated, and the rectum and bladder are connected together to form a cavity called the cloaca. When the embryo reaches the seventh week of development, the mesoderm grows downward, separating the rectum from the urogenital sinus, and the rectum progresses toward the perineum while the urogenital sinus forms the bladder, urethra or vagina. By the ninth week, the rectum extends downward, penetrating the pelvic and anal membranes to connect with the primitive anus and form the rectoanal canal.
Anal atresia occurs when the primordial anus is stunted and does not recess inward to form an anal canal.
The cause of the dysplasia is not known, but it is now commonly believed that the occurrence of anal atresia, like other congenital anomalies, may be associated with viral infections, chemicals, environmental and nutritional factors during gestation, especially in early pregnancy.
Clinical manifestations
1, mostly manifested as low intestinal obstruction, the child is born without meconium discharge, and soon vomiting, bloating and other symptoms of gastrointestinal obstruction, the vomit is milk or bile or even fecal odor-like material.
2, perineal examination, the vast majority of children with anal atresia are born without an anus, with a flat central perineum and a small depression with pigmentation.
Some children have both rectourethral fistula and rectovaginal fistula, and the meconium is discharged from the urethra or vagina, and the urine is cloudy. However, the early signs of obstruction are usually not obvious because the feces can be drained through the fistula.
Some children may also have congenital malformations in other areas.
Classification
Depending on the location of the atresia, it can be classified as high atresia, intermediate atresia, or low atresia.
Treatment
For congenital anal atresia, treatment is mainly surgical, and different surgical methods and times are used depending on the location of the atresia and the presence of fistula formation.
High anal atresia requires early surgery, and it is advisable to perform transverse colostomy or sigmoid colostomy first and then sacro-abdominal perineal anoplasty after 6-12 months.
2.Sacro-perineal anoplasty should be performed at about 6 months of age for children with intermediate anal atresia. For children with median malformation without fistula and with rectourethral fistula, colostomy should be performed first to relieve the obstructive symptoms. In the case of low rectovaginal fistula, the fistula is large and the normal defecation can be maintained for a period of time, so it is not necessary to make a stoma.
3, low anal closure of children feasible feasible perineal anoplasty. For those who do not have fistula or have fistula but cannot defecate, the operation usually needs to be completed within 1-2 days after birth. For those with larger fistulas who can still maintain normal defecation for a period of time after birth, surgery can be performed around 6 months of age.
Warm tips
The occurrence of congenital anal atresia may be related to genetics and environmental factors, so we should take a scientific attitude to actively prevent it, avoid adverse environmental factors as much as possible, take the initiative to conduct marriage tests, and receive pregnancy health checks on time.