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DELAYED DIAGNOSIS OF ANORECTAL MALFORMATION: THE NEED FOR CAREFUL NEONATAL EXAMINATION
Author(s) -
Etheridge C. E.,
Holland A. J. A.,
Soundappan S. V. S.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04125_4.x
Subject(s) - medicine , perineum , vomiting , pediatrics , surgery , abdominal distension , retrospective cohort study , medical diagnosis , constipation , pathology
Purpose To determine the frequency of delayed diagnosis of anorectal malformation in infants admitted to our institution and determine the resulting morbidity and mortality. Methodology A retrospective review was performed of all anorectal malformations treated at the Children’s Hospital at Westmead between November 1995 and November 2006. A detailed review was performed of those infants in whom the diagnoses was made greater than 24 hours after birth. Results 175 anorectal malformations were seen at this institution over the 11 year review period. Diagnostic delay occurred in 5 (3%): four of which were male. The four males were diagnosed within the first week of life, presenting with abdominal distension, vomiting and intestinal obstruction. The single female was diagnosed at 6 months of age when at onset of solid foods she became acutely obstructed. Delayed diagnosis was found to complicate the surgical repair and may have contributed to functional and psychological issues for patients and their families. One case of delayed diagnosis resulted in the death of the child. Conclusion Delayed diagnosis of anorectal malformations should be entirely avoidable but occurred in 3% of all cases presenting to our institution. It was associated with morbidity and even mortality. Careful inspection of the neonatal perineum at birth should allow all anorectal malformations to be consistently detected.