Pattern of anorectal malformation in a tertiary care hospital of Bihar

Authors

  • Zaheer Hasan Department of Paediatric Surgery, Indira Gandhi institute of Medical Science, Patna, Bihar, India
  • Vinit Kumar Thakur Department of Paediatric Surgery, Indira Gandhi institute of Medical Science, Patna, Bihar, India
  • Ramdhani Yadav Department of Paediatric Surgery, Indira Gandhi institute of Medical Science, Patna, Bihar, India
  • Digamber Chaubey Department of Paediatric Surgery, Indira Gandhi institute of Medical Science, Patna, Bihar, India

DOI:

https://doi.org/10.18203/2349-2902.isj20203249

Keywords:

Anorectal malformation, Bihar, Hospital, Pattern, Tertiary care

Abstract

Background: Anorectal malformation (ARM) is common cause of neonatal intestinal obstruction and is one of the most common neonatal surgical emergency encountered by paediatric surgeons. There is no published study about the prevalence of ARM cases within the referral zone of the hospital. This study was done to demonstrate the burden of Anorectal malformation and their surgical intervention as seen in Indira Gandhi Institute of medical science, Patna, Bihar.

Methods: Data were retrospectively collected over a period of four years between January 2015 and December 2018. The data collected were demographic status of the patient, diagnosis, associated anomaly, duration of hospital stay and their surgical intervention.

Results: There were 395 cases of anorectal malformation out of 93203 OPD patients (0.42%). Male to female ratio of 3.01:1.  ARM also represented 25.3%   of neonatal emergency surgical procedures. The majority of the patient had presented in the neonatal period (51.6%) with mean weight of 2.6 kg. The most common type of ARM found in male patient was rectourethral fistula n=215 (54.4%) in which 164 (76.2%) patients were with rectobulbar fistula and 51 (23.8%) patients had rectoprostatic fistula. Sixty nine (17.4%) female patients presented with perineal fistula.

Conclusions: We found a clear male preponderance of anorectal malformation in our study. Patients affected were mostly from poor socioeconomic strata of the society. Present study confirms huge work load of anorectal malformation in this region. This will be helpful in future planning and effective management including financial constraints of the treatment for our poor patients.

Author Biographies

Zaheer Hasan, Department of Paediatric Surgery, Indira Gandhi institute of Medical Science, Patna, Bihar, India

department of pediatric surgery

additional professor

Vinit Kumar Thakur, Department of Paediatric Surgery, Indira Gandhi institute of Medical Science, Patna, Bihar, India

dept of pediatric surgery

additional professor

Ramdhani Yadav, Department of Paediatric Surgery, Indira Gandhi institute of Medical Science, Patna, Bihar, India

associate prof, pediatric surgery

Digamber Chaubey, Department of Paediatric Surgery, Indira Gandhi institute of Medical Science, Patna, Bihar, India

assistant prof, pediatric surgery

References

Pena A, Levitt MA. Anorectal malformations. In: Grosfeld JL, O’Neill JA Jr, Coran AG, Fonkalsrud EW, Caldamone AA. eds. Pediatric surgery. 6th ed. Chicago (IL): Year Book; 2006:1566-1586.

Ameh EA, Dogo PM, Nmadu PT. Emergency neonatal surgery in a developing country. Pediatr Surg Int. 2001;17:448-45.

Aristotle. Generation of Animals. Peck AL (trans.) Chapter IV. Harvard University Press, Cambridge; MA book IV; 1953:444-447.

Amussat JZ. History of a successful artificial artificial aus operation with a new process. Gaz Med Paris. 1835;3:753-8.

Holschneider AM, Hutson JM, Peña A, Bekhit E, Chatterjee S, Coran A, et al. Preliminary report on the international conference for the development of standards for the treatment of anorectal malformation. J Ped Surg. 2005;40:1521-6.

Murphy F, Puri P, Hutson JM, Holschneider AM. Incidence and frequency of different types, and classification of anorectal mal-formations. In: Holschneider AM, Hutson JM, eds. Anorectal malformations in children. Berlin Heidelberg New York: Springer; 2006:163-184.

Peña A, Levitt MA. Anorectal malformations: experience with posterior sagittal approach. In: Stringer M, Oldham K, Mouriquand P, eds. Pediatric Surgery and Urology. 2nd edn. Long-term Outcomes. Cambridge: Cambridge University Press; 2006:401-415.

Nah SA, Ong CCP, Lakshmi NK, Yap TL, Jacobsen AS, Low Y. Anomalies associated with anorectal malformations according to the Krickenbeck anatomical classification. J Pediatr Surg. 2012;47:2273-8.

Endo M, Hayashi A, Ishihara M, Maie M, Nagasaki A, Nishi T, et al. Analysis of 1992 patients with anorectal malformations over the past two decades in Japan. Steering committee of Japanese study group of anorectal anomalies. J Pediatr Surg. 1999;34:435-41.

Stoll C, Alembik Y, Dott B, Roth MP. Associated malformations in patients with anorectal anomalies. Eur J Med Genet. 2007;50:281-90.

Cuschieri A. EUROCAT Working Group. Anorectal anomalies associated with or as part of other anomalies. Am J Med Genet. 2002;110:122-30.

Chen CJ. The treatment of imperforate anus: experience with 108 patients. J Pediatr Surg. 1999;34:1728-32.

Cho S, Moore SP, Fangman T. One hundred three consecutive patients with anorectal malformations and their associated anomalies. Arch Pediatr Adolesc Med. 2001;155:587-91.

Wheeler PG, Weaver DD. Adults with VATER association: long-term prognosis. Am J Hum Genet A. 2005;138A:212-7.

Peña A, Devries PA. Posterior sagittal anorectoplasty: important technical considerations and new applications. J Pediatr Surg. 1982;17:796-811.

Gangopadhyay AN, Gopal SC, Sharma S, Gupta DK, Sharma SP, et al. Management of anorectal malformations in Varanasi, India: A long-term review of single and three stage procedures. Pediatr Surg Int. 2006;22(2):169-72.

Godse AS, Best KE, Lawson A, Rosby L, Rankin J. Register based study of anorectal anomalies over 26 years: Associated anomalies, prevalence, and trends. Birth Def Res. 2015;103:597-602.

Downloads

Published

2020-07-23

Issue

Section

Original Research Articles