Title

Anorectal anomalies and Hirschsprung disease (including stomas)

Document Type

Journal Article

Publication Date

1-1-2013

Journal

Surgery (United Kingdom)

Volume

31

Issue

12

DOI

10.1016/j.mpsur.2013.10.003

Keywords

Aganglionosis; anorectal malformation; Duhamel procedure; imperforate anus; PSARP; Soave procedure; Swenson procedure; transition zone; VACTERL association

Abstract

Anorectal malformations are congenital anomalies caused by a failure of the hindgut to open into an adequate position on the perineum. They are often associated with congenital anomalies in other systems. A thorough understanding of the anatomical aberration will allow surgical planning and correction of the defect. This article outlines the principle considerations in diagnosis, early and definitive management of these defects. Hirschsprung disease is a congenital anomaly caused by a failure of development of the enteric nervous system and consequent absence of ganglia. Marked spasticity of the bowel and functional bowel obstruction ensue. This article discusses recognition, diagnosis, initial and definitive management. In both conditions sequelae include life-long incontinence. Optimization of long-term outcomes is therefore important and meticulous surgical management in early life should be coupled with careful follow-up. © 2013 Elsevier Ltd. All rights reserved.

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