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Imperforate Anus:     more detail

Proctology: Defecation, Hemorrhoid, Anal Fissure, Germ Cell Tumor, Anal Fistula, Stapled Hemorrhoidectomy, Imperforate Anus, Proctalgia Fugax Report of a successful operation for artificial anus, in a case of imperforate rectum by Manning Simons, 1878 Imperforate anus, bowel opening into urethra, hypospadias: A presentation of new plastic methods by Hugh H Young, 1936 Anorectal Malformations in Children by Alexander M. Holschneider, 2006-11-14

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1. Imperforate Anus
   Information page including definitions, from Texas Pediatric Surgical AssociatesCategory Health Conditions and Diseases Anorectal imperforate anusimperforate anus. What is imperforate anus? imperforate anus is the absenceof a normal anal opening. How is imperforate anus evaluated?  
   http://www.pedisurg.com/PtEduc/Imperforate_Anus.htm
   
   Extractions: IMPERFORATE ANUS What is imperforate anus? Imperforate anus is the absence of a normal anal opening. The diagnosis is usually made shortly after birth by a routine physical examination. Imperforate anus occurs in about 1 in 5000 births and its cause is unknown. Children who have imperforate anus may also have other congenital anomalies. The acronym VACTERL describes the associated problems that infants with imperforate anus may have: Vertebral defects, Anal atresia, Cardiac anomalies, Tracheoesophageal fistula, Esophageal atresia, Renal anomalies, and Limb anomalies. The incidence of kidney and bladder problems increases with the severity of the imperforate anus, ranging from 5 to 20 percent with low lesions up to 60 to 90 percent with high lesions. While some of these anomalies may be noted on physical examination, others require further diagnostic tests. Renal ultrasound is done shortly after birth on all infants to evaluate the kidneys. Chest X-ray, EKG, and cardiac ultrasound may be ordered to evaluate the heart. Other X-rays may be done to evaluate the trachea and esophagus and the spine. How is imperforate anus evaluated?

2. MEDLINEplus Medical Encyclopedia: Imperforate Anus Repair
   Surgery for a high type imperforate anus defect usually involves creation of a temporary opening of the large intestine  
   http://www.nlm.nih.gov/medlineplus/ency/article/002926.htm
   
   Extractions: Skip navigation Other encyclopedia topics: A-Ag Ah-Ap Aq-Az B-Bk ... Z Contents of this page: Imperforate anus repair - series Alternative names Return to top Anorectal malformation repair; Perineal anoplasty Definition Return to top Surgery to correct one of several birth defects involving malformation of the rectum and anus ( imperforate anus ). in individuals with a normal anatomy, the large intestine (colon) empties into a pouch-like portion of bowel (rectum). Through complex nerve and muscle structures, the rectum releases stool through the anus out of the body. Infants with imperforate anus defect have malformations of the rectum and anus, in which abnormal development of these structures leads to growth of skin over the anus, and incomplete development of the rectum. As a result, these infants have either no anal opening through which stool can pass, or a very small fistulous opening (channel that connects skin to bowel) that allows only a small amount of stool to pass out of the rectum. Variations of the defect include: complete absence of an anal opening a small tube-like opening ( fistula ) from the bowel to the skin

3. Imperforate Anus Repair
   defects involving malformation of the rectum and anus (imperforate anus). in individuals with a normal anatomy, the  
   http://www.pennhealth.com/ency/article/002926.htm
   
   Extractions: Disease Injury Nutrition Poison ... Risks Definition: Surgery to correct one of several birth defects involving malformation of the rectum and anus ( imperforate anus ). in individuals with a normal anatomy, the large intestine (colon) empties into a pouch-like portion of bowel (rectum). Through complex nerve and muscle structures, the rectum releases stool through the anus out of the body. Infants with imperforate anus defect have malformations of the rectum and anus, in which abnormal development of these structures leads to growth of skin over the anus, and incomplete development of the rectum. As a result, these infants have either no anal opening through which stool can pass, or a very small fistulous opening (channel that connects skin to bowel) that allows only a small amount of stool to pass out of the rectum. Variations of the defect include:

4. Suprapubic Tube Malposition
   Robert L. Lebowitz, M.D. Children' s Hospital, Harvard Medical School CALCIFIED INTRALUMINAL MECONIUM IN imperforate anus Calcified intraluminal meconium on prenatal ultrasound (figure 1).  
   http://www.duj.com/PUR/PUR57.html
   
   Extractions: Boston, Massachusetts Calcified intraluminal meconium on prenatal ultrasound (figure 1) . Confirmed after delivery with calcifications in region of a redundant sigmoid colon (arrow, figure 2) . The baby underwent diverting colostomy. There was difficulty in catheterizing him, and so a suprapubic tube was placed. A voiding cystourethrogram was done through the suprapubic tube and showed reflux into a long utricle (u), and reflux through the rectourethral communication into the blind-ending rectum (r) and then out through the distal limb of the colostomy (figure 3) . The urethra was otherwise normal. When urine and meconium mix in the lumen of the bowel of the fetus, the meconium often calcifies. Therefore, when one sees calcified intraluminal meconium, either in utero of after delivery, the usual diagnosis in a boy is high imperforate anus, and in a girl, the cloacal malformation. Return to Pediatric Uroradiology Rounds

5. Constipation
   as they are rarely necessary, although they can be helpful in establishing aboweltraining regimen in patients after operation for imperforate anus.  
   http://www.pedisurg.com/PtEduc/Constipation.htm
   
   Extractions: CONSTIPATION What is constipation? Constipation is a very common problem in infants and children and is frequently seen by both pediatricians and family doctors. Most of the time, reassurance, dietary changes, and laxatives are effective treatment for both the patient and family. Constipation can occur at any age and the evaluation and treatment may be different depending on the child's age. The newborn infant should have his/her first stool within the first 24 hours after birth. Failure to pass stool by 48 hours of life may signify a more serious condition such as Hirschsprung's disease, meconium ileus due to cystic fibrosis, or hypothyroidism and further evaluation of the infant is needed. Constipation is usually diagnosed when an infant or child has hard stools or has difficulty stooling. This condition can be quite distressing for the family but is usually easy to treat. Infants are noted to strain excessively and have difficulty passing stools, even though their stools are of normal consistency. The difficulty in passing stool is thought to represent a delay in maturation of intestinal motility and is self-resolving; use of glycerin suppositories may be helpful. The frequency of bowel movements in infants varies considerably, and an infant who has soft, pain-free, but infrequent stools is not constipated and does not need further evaluation. As the child gets older, constipation can be due to a large number of factors including anal fissure, diet lacking in fiber and fluids, overuse of laxatives, family or behavior problems, and (rarely) ectopic anus. Constipation in children can also present, paradoxically, as watery diarrhea and incontinence due to overflow around impacted stool, a condition called encopresis.

6. MEDLINEplus Medical Encyclopedia: Imperforate Anus Repair - Series: Normal Anato
   imperforate anus repair series Normal anatomy. imperforate anus repair - series Illustrations  
   http://www.nlm.nih.gov/medlineplus/ency/presentations/100030_1.htm
   
   Extractions: Skip navigation Imperforate anus repair - series: Normal anatomy Imperforate anus repair - series Illustrations: Normal anatomy Indications Procedure Aftercare In individuals with a normal anatomy, the large intestine (colon) empties into a pouch-like portion of bowel (rectum). Through complex nerve and muscle structures, the rectum releases stool through the anus out of the body.

7. MEDLINEplus Medical Encyclopedia: Imperforate Anus
   imperforate anus. Causes, incidence, and risk factors Return to top imperforate anusis a malformation of the anorectal region that may occur in several forms.  
   http://www.nlm.nih.gov/medlineplus/ency/article/001147.htm
   
   Extractions: Skip navigation Other encyclopedia topics: A-Ag Ah-Ap Aq-Az B-Bk ... Z Contents of this page: Digestive system Imperforate anus Imperforate anus repair - series Alternative names Return to top Anorectal malformation; Anal atresia Definition Return to top A congenital absence or obstruction of the anal opening. Causes, incidence, and risk factors Return to top Imperforate anus is a malformation of the anorectal region that may occur in several forms. The rectum may end in a blind pouch that does not connect with the colon. Or, it may have openings to the urethra, bladder, base of penis or scrotum in boys, or vagina in girls. A condition of stenosis (narrowing) of the anus or absence of the anus may be present. The malformations are caused by abnormal development of the fetus, and many are associated with other birth defects. Imperforate anus is a relatively common congenital malformation that occurs in about 1 out of 5,000 infants. Symptoms Return to top Signs and tests Return to top A physical examination with check for anal patency in the newborn will show the malformation.

8. ThirdAge - Adam - Imperforate Anus
   Activities Beauty Style Computers Family Tree Health Horoscopes Love Money Travel Overview Symptoms Treatment Prevention imperforate anus Definition A congenital absence or obstruction of the anal opening. Alternative Names  
   http://www.thirdage.com/health/adam/ency/article/001147.htm
   
   Extractions: Causes, incidence, and risk factors: Imperforate anus is a malformation of the anorectal region that may occur in several forms. The rectum may end in a blind pouch that does not connect with the colon. Or, it may have openings to the urethra, bladder, base of penis or scrotum in boys, or vagina in girls. A condition of stenosis (narrowing) of the anus or absence of the anus may be present.

9. µL¨z¯g¡EImperforate Anus Family Association
   Since Nov.1996 TaiwanCategory Health Conditions and Diseases Anorectal imperforate anusimperforate anus Family Association Since Nov.1996 . ?. imperforate anus. ?  
   http://www2.mmh.org.tw/ssd/imperf2.htm
   
   Extractions: Imperforate Anus Family Association ¬°¯fµhªº¨­¤ß ¿U°_§Æ±æªº¤õ¬² ¤°»ò¬OµL¨z¯g? µL¨z¯g¤§¤Àþ»PªvÀø µL¨z¯g¯fµ£¸Ó¦p¦ó·ÓÅU µL¨z¯g³Ì¤jªº§xÂZ¬O¤°»ò ... ¡z Updated : 1999.12.3 ªÀªA«Ç¤£©w´Á´£¨Ñ¤§ªA°È »Pºë¯«¬ìÂå®v¦X¿ì¡y¨àµ£¹CÀ¸ªvÀø¹ÎÅé¡z »Pºë¯«¬ìÂå®v¦X¿ì¡y«C¤Ö¦~¦¨ªøÀç¡z »s­q¤â¥U¨´£¨ÑÂå¾Ç·sª¾¸ê®Æ¨Ñ®aÄÝ°Ñ¦Ò ¯fµ£»P®aªø¡y¾Ç²ßÄé¸z¡z°V½m¹ÎÅé ¯fµ£Âù¿Ë¡y¿Ë¤lºÞ±Ð·¾³q¹ÎÅé¡z ¯fµ£»P®aªø¡y¼v¤ù½àªR¡z ®L¥OÀç»P¥V¥OÀç

10. Pediatric Surgery | Minimally Invasive Surgery | Imperforate Anus
    Minimally Invasive Surgery, Print Format. imperforate anus. imperforate anusis a birth defect that occurs in about one of every 5,000 newborns.  
    http://www.ucsfhealth.org/childrens/medical_services/surgical/minimal/conditions
    
    Extractions: Pediatric Surgery Topics Minimally Invasive Surgery To Visit Us Our Experts ... Events and Classes Request an appointment, get directions and phone numbers, find hospital visiting hours and more Choose a doctor from among the 900 experts on our staff Events calendar, medical dictionary, news, patient education and other online resources Minimally Invasive Surgery Print Format Imperforate Anus Signs and Symptoms Treatment Signs and Symptoms Imperforate anus is a birth defect that occurs in about one of every 5,000 newborns. It is somewhat more common in boys than girls and may include a single abnormality or a combination of abnormalities of the rectum, (the end of the intestine near the anus), and anus, (the opening of the rectum). There is no known cause for this condition. There are many forms of this birth defect including: The absence of an anal opening.

11. Urinary Dribbling
    Robert L. Lebowitz, M.D. Children' s Hospital, Harvard Medical School RECTOURINARY COMMUNICATIONS IN THE BOY WITH HIGH imperforate anus  
    http://www.duj.com/PUR/PUR76.html

12. Pediatric Surgery | Minimally Invasive Surgery | Imperforate Anus
    medical dictionary, news, patient education and other online resources.Minimally Invasive Surgery, Print Format. imperforate anus.  
    http://www.ucsfhealth.org/childrens/medical_services/surgical/minimal/conditions
    
    Extractions: Pediatric Surgery Topics Minimally Invasive Surgery To Visit Us Our Experts ... Events and Classes Request an appointment, get directions and phone numbers, find hospital visiting hours and more Choose a doctor from among the 900 experts on our staff Events calendar, medical dictionary, news, patient education and other online resources Minimally Invasive Surgery Print Format Imperforate Anus Signs and Symptoms Treatment Diagnosis If the anal opening is missing or in the wrong position, it can be identified by a physical examination. If there is stool coming out of the urethra or vagina, it will be seen as the baby passes urine. Home About Us Contact Us Jobs UCSF Campus University of California ... Compliance

13. ELibrary.com - The Mosby Medical Encyclopedia 10-01-1996,
    eLibrary is the subscription based online library for fun or research. Find out more about securing your guaranteed Free 7day trial with your credit card and retrieve 'eLibrary.com - The Mosby Medical Encyclopedia 10-01-1996, 'imperforate anus''  
    http://redirect-west.inktomi.com/click?u=http://ask.elibrary.com/getdoc.asp%3Fpu

14. Imperforate Anus: Background
    Anorectal Malformations imperforate anus. General Background. Animperforate anus is caused by this process not being completed.  
    http://www.pullthrough.org/Background.html
    
    Extractions: Anorectal Malformations: Imperforate Anus General Background All anorectal malformations have routinely been classified by the term "imperforate anus," a condition recognized since antiquity. Studies show that anorectal malformations occur in varying degrees in one out of every 4,000 newborns. This translates to approximately 600 children born each year in the U.S. Females seem to suffer this condition less frequently than males. There is no known cause for the condition which runs equally through all racial, social, cultural and economic groups. One thing is known: Parents should never blame themselves for the condition. There is no evidence to suggest it is caused by something done as an adolescent, on the night of conception or during the pregnancy. The complex miracle of reproduction sometimes just goes astray. These defects probably develop during the 4th to 12th week of gestation. As the fetus grows, all of the internal organs begin in a mass, and slowly spread out, until they separate. During normal development, the urethra and lower colon begin distending as one, and separate before completing their respective descents. An imperforate anus is caused by this process not being completed. The uncompleted developmental steps must be done surgically. There are many types of anorectal malformations. Each one has specific characteristics and carries a specific prognosis. When the colon is located high in the pelvis, most surgeons describe it as

15. PTN Glossary-Diagnosis
    instead of at the tip. Back to the TOP High imperforate anus /Anorectal Malformation. High imperforate anus is a congenital  
    http://www.pullthrough.org/glossary/diagnosis.htm
    
    Extractions: Caudal Regression Caudal Regression Syndrome is a rare disorder characterized by abnormal development of the lower spine end of the developing fetus. A wide range of abnormalities may occur including partial absence of the tailbone end of the spine causing no apparent symptoms, to extensive abnormalities of the lower vertebrae, pelvis, and spine. Neurological impairment as well as inability to control urination and bowel movements (incontinence) may occur in severe cases.

16. EMedicine - Imperforate Anus : Article By Daniel A Beals, MD
    imperforate anus Congenital anomalies of the anus and rectum are relativelycommon. imperforate anus. Last Updated August 10, 2002,  
    http://www.emedicine.com/ped/topic1171.htm
    
    Extractions: (advertisement) Home Specialties CME PDA ... Patient Education Articles Images CME Patient Education Advanced Search Link to this site Back to: eMedicine Specialties Pediatrics Gastroenterology Last Updated: August 10, 2002 Rate this Article Email to a Colleague Synonyms and related keywords: anal atresia, anal stenosis, covered anus, rectourethral fistula, anal agenesis, anterior ectopic anus, perineal fistula, rectoprostatic fistula, rectal fistula, cloacal malformation, Currarino syndrome, anorectal anomaly AUTHOR INFORMATION Section 1 of 9 Author Information Introduction Clinical Workup ... Bibliography Author: Daniel A Beals, MD , Associate Professor, Department of Surgery, Section of Pediatric Surgery, University of Kentucky Daniel A Beals, MD, is a member of the following medical societies: American Society for Bioethics and Humanities Editor(s): Hisham Nazer, MD , Professor, Department of Pediatrics, University of Jordan, Amman, Jordan; Mary L Windle, PharmD , Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy;

17. EMedicine - Imperforate Anus : Article Excerpt By: Daniel A Beals, MD
    imperforate anus Congenital anomalies of the anus and rectum arerelatively common. Minor Excerpt from imperforate anus. Synonyms  
    http://www.emedicine.com/ped/byname/imperforate-anus.htm
    
    Extractions: (advertisement) Synonyms, Key Words, and Related Terms: anal atresia, anal stenosis, covered anus, rectourethral fistula, anal agenesis, anterior ectopic anus, perineal fistula, rectoprostatic fistula, rectal fistula, cloacal malformation, Currarino syndrome, anorectal anomaly Background: Congenital anomalies of the anus and rectum are relatively common. Minor abnormalities occur in approximately 1 per 500 live births; major anomalies occur in 1 per 5000 live births. Among the various anomalies associated with rectal abnormalities are malformations of the urinary tract and esophagus and, less often, the small bowel. The most useful clinical classification categorizes lesions by whether the rectum passes through the puborectalis muscle sling. High lesions fail to pass through this muscle complex and are more likely to elicit long-term continence problems. Low lesions traverse this muscle complex, and patients with these conditions generally have a better prognosis. In either case, skilled evaluation by a pediatric surgeon improves the infant’s chance of continence and normal lifestyle. Pathophysiology: The anus and rectum develop from the dorsal potion of the hindgut or cloacal cavity when lateral ingrowth of the mesenchyme forms the urorectal septum in the midline. This septum separates the rectum and anal canal dorsally from the bladder and urethra. The cloacal duct is a small communication between the 2 portions of the hindgut; downgrowth of the urorectal septum closes this duct by the seventh week of gestation. During this time, the ventral urogenital portion acquires an external opening; the dorsal anal membrane opens later. The anus develops by a fusion of the anal tubercles and an external invagination, known as the proctodeum, which deepens toward the rectum but is separated from it by the anal membrane. This separating membrane should disintegrate during the eighth week of gestation.

18. Imperforate Anus
    imperforate anus Anorectal Malformation providing links to detailed supportinformation. Constipation - after operation for imperforate anus.  
    http://www.ability.org.uk/Imperforate_Anus.html
    
    Extractions: Our Aims Services Stats ... Z Imperforate Anus Anorectal Malformation - providing links to detailed support information. Anorectal Malformations Discussion Groups - Links to discussion groups and mailing lists Cecostomy.com - A new technique and catheter changing the lives of patients with fecal incontinence Center for Rare Disorders - Abstracts: Primary repair of imperforate anus in an adult. Congenital Pediatrics - University of Wisconsin Department of Surgery. Constipation - after operation for imperforate anus. Constipation treatment, prevention, and much more. Currarino Triad Homepage - Named after the syndrome's discoverer, Dr. Guido Currarino. Automsomal dominant condition (that is non-sex-linked dominant) with a 50% chance of being passed on to future generations by all affected family members. Digestive System Defects - Developmental Defects of the Digestive System DrKoop.com: Medical Encyclopedia - Pediatric - Imperforate anus repair general overview and information. EImperforate Anus Family Association The Fetal Treatment Center at UCSF Frequently Asked Questions (FAQ) Health Answers: Medical Reference Library ... Imperforate Anus - Info page including definitions.

19. Health Ency.: Surgery: Imperforate Anus Repair
    imperforate anus repair. Definition Surgery to correct one of several birthdefects involving malformation of the rectum and anus (imperforate anus).  
    http://www.austin360.com/shared/health/adam/ency/article/002926.html
    
    Extractions: Important notice Ency. home Surgery I Imperforate anus repair Overview Recovery Risks Alternative names: Anorectal malformation repair; Perineal anoplasty Definition: Surgery to correct one of several birth defects involving malformation of the rectum and anus ( imperforate anus ). in individuals with a normal anatomy, the large intestine (colon) empties into a pouch-like portion of bowel (rectum). Through complex nerve and muscle structures, the rectum releases stool through the anus out of the body. Infants with imperforate anus defect have malformations of the rectum and anus, in which abnormal development of these structures leads to growth of skin over the anus, and incomplete development of the rectum. As a result, these infants have either no anal opening through which stool can pass, or a very small fistulous opening (channel that connects skin to bowel) that allows only a small amount of stool to pass out of the rectum. Variations of the defect include: complete absence of an anal opening a small tube-like opening ( fistula ) from the bowel to the skin

20. Health Ency.: Disease: Imperforate Anus
    imperforate anus See images. Causes and Risks. imperforate anus is a malformationof the anorectal region that may occur in several forms.  
    http://www.austin360.com/shared/health/adam/ency/article/001147.html
    
    Extractions: Important notice Ency. home Disease I Imperforate anus See images Overview Symptoms Treatment ... Prevention Alternative names: Anorectal malformation; Anal atresia Definition: A congenital absence or obstruction of the anal opening. Causes and Risks Imperforate anus is a malformation of the anorectal region that may occur in several forms. The rectum may end in a blind pouch that does not connect with the colon. Or, it may have openings to the urethra, bladder, base of penis or scrotum in boys, or vagina in girls. A condition of stenosis (narrowing) of the anus or absence of the anus may be present.

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