Newborns with Anorectal Malformations / Imperforate Anus
Congratulations, parents, on the birth of your new baby. This is a very exciting time for you. Colorectal Center staff at Cincinnati Children's Hospital Medical Center will do everything we can to make this time as easy on you and your family as possible.
Having an anorectal malformation / imperforate anus is only one area of your child that is affected. Your baby will need lots of love and attention during this time. Your baby is an important part of your family and will need support from you, your children and their grandparents.
This is not a condition over which either parent could have had any control. It is not something you ate, drank or did during your pregnancy. This is a condition that affects about 600 children each year in the United States. The good news is today our surgical techniques and postoperative care have improved dramatically.
The first half of this century was characterized in pediatric surgery by the advent of new surgical techniques designed to treat congenital defects. This, of course, required a detailed description of the basic anatomy of each one of the most common defects.
Thus, with relatively small effort, pioneers of this century made remarkable contributions in the field of pediatric surgery, which allowed the repair of those defects, integrating to normal life many previously unfortunate children.
Everyone at the Colorectal Center at Cincinnati Children's wants you to know that you are doing what is right for your baby and its care. Knowledge is power and we want to provide you with as much information as possible to help you to prepare for what is ahead in your child's life.
A Spectrum of Anorectal Malformations and Treatments
It is difficult to classify anorectal malformations with simple clarity regarding the discrete number of variations in defects, diagnostic methods, medical and surgical therapies and postoperative programs. That is because there is a very large spectrum of defects and treatments.
Consequently, it is important to seek specialized medical consultation as soon as possible.
However, for purposes of enlightening parents of children with this disorder, we will attempt to provide as much information as we can on anorectal malformations / imperforate anus and their therapies. However, we suggest that you use this information only with the addition of medical advice.
As you learn about anorectal malformations / imperforate anus, we have thought of some basic questions you might have considered.
What is the incidence of anorectal malformation / imperforate anus?
Approximately one in 4,000 children are born with a anorectal malformation. The best chances for a good outcome for a child born with this disorder comes when there is an immediate and correct diagnosis and treatment of the disorder at the time of birth. What are the different defects, diagnoses and therapies?
There are different defects, diagnoses and therapies associated with males and females. Be certain that your attending physician is aware of these different defects. Why does my child need a colostomy?
A colostomy -- or other type of ostomy -- is most commonly required to treat a child born with (only) an anorectal malformation. This surgical procedure creates a stoma, which is an opening in the abdomen through with waste passes. From that point forward, future chances for bowel control are based on the complexity of each child's colorectal malformation. What is the best age for a child to have a pull-through procedure?
Typically, after the child has grown some (generally four to eight weeks later and when there is normal growth in the child and no other associated defects), the next step will be to perform a pull-through procedure. At the same time, or sometimes a little later, there will be a colostomy closure procedure. Can any pediatric surgeon do this surgery?
All pediatric surgeons are trained to take care of all pediatric surgical problems. Some surgeons may only see a baby with an anorectal malformation once or twice a year, and maybe 20 or so through their career.
At the Cincinnati Children's Colorectal Center, Dr. Alberto Peña and Dr. Marc Levitt, operate on 80 to 100 children a year. Their team has the largest series of patients in the world, over 1850 patients.
There are many excellent pediatric surgeons throughout the world, and many of these surgeons are extremely competent to perform this surgery. You should ask your surgeon how many cases they have treated. Ask to talk to some of the parents of children who were their patients.
The bottom line is to work with the surgeon with whom you feel most comfortable. Talk to other parents. Parents' organizations such as the Pullthrough Network are an excellent source of information. The Colorectal Center also provides references to other parent information organizations as well. Is my child going to have bowel control?
The vast majority of children can potty train normally and have voluntary bowel movements. For the small group who do not have this capacity, an articificial way of keeping them clean and dry is by a bowel management program.
For more information or to request an appointment, please contact the Colorectal Center at Cincinnati Children's.
