Anorectal malformations
Introduction
Introduction Anorectal malformation is a common gastrointestinal malformation. It has a wide variety of pathological complexes. Not only the development of the anorectal itself, but also the muscles around the anus - the puborectalis, the external anal sphincter and the internal sphincter have different degrees of changes. One of the important changes in malformation, in addition to the high incidence of malformations associated with other organ malformations, some cases of multiple malformations or severely endanger the life of the sick child.
Cause
Cause
The occurrence of anorectal malformation may be related to the occurrence of viral infection, chemical substances, environment and nutrition during pregnancy, especially in early pregnancy (4-12 weeks). The earlier the developmental disorder occurs in the embryonic stage, the higher the position and the more complicated the deformity is.
Examine
an examination
Related inspection
Anal reflex anus examination anal examination of vaginal anterior and posterior wall bulging
1. Inverted lateral X-ray film: It is required to take more than 12 hours after birth, waiting for the gas to reach the rectum, and the living ability is poor, it takes longer. A tincture is applied to the skin of the perineal anal area as a marker.
2, fistula angiography: fistula angiography requires the image of the colon when the contrast agent is injected and the image of the rectal fistula when the contrast agent is discharged. Double contrast of the colorectal and urethra can show the relationship between the rectal fistula and the urethra. Vaginal angiography can show the relationship between the vagina and the rectum.
Diagnosis
Differential diagnosis
Diagnosis of anorectal malformation:
There are many types of congenital anorectal malformations, and their clinical symptoms are different, and the time of symptoms varies. Some children develop acute intestinal obstruction after birth, and some have difficulty in defecation for a long time after birth. Even a small number of children have no symptoms or mild symptoms for a long time. Most children with anorectal malformations do not have an anus in the normal anus position. Anorectal malformation should be thought of when the baby is not discharged 24 hours after birth. It should be checked in time for about 3/4 cases, including all innocent anorectal atresia, and some of them may be sputum, but the mouth is narrow and can not discharge meconium or only Can discharge a small amount of meconium, such as rectal bladder fistula, urethral fistula, etc., vomiting after feeding, spit out for milk, and can contain sputum after bile, the abdomen gradually expands, the condition is increasingly serious, such as undiagnosed and treated , 6 to 7 days can die. Another part of the case, including anorectal stenosis and vaginal fistula, vestibular spasm and perineal fistula, and thick fistula, do not appear intestinal obstruction for a period of time after birth, but defecation in weeks, months, or even years later Difficulties, thinning of the abdomen, and sometimes large feces in the lower abdomen. There has been a change in secondary megacolon at this time.
Mainly differentiated from rectal atresia:
Rectal atresia is a certain distance between the blind end of the rectum and the anus. It is caused by the primordial anal dysplasia during the fetal period. The symptoms are more serious than the lock anal. The degree of swelling around the anus is smaller than that of the lock anus.
