Management in the newborn period

Document Type

Journal Article

Publication Date



Anorectal Malformations in Children: Embryology, Diagnosis, Surgical Treatment, Follow-up




Figure 19.1 shows the decision-making algorithm for the initial management of male patients with anorectal malformations. When one is called to see a newborn male with an anorectal malformation, a thorough perineal inspection must be performed. This usually gives the most important clues about the type of malformation that the patient has. It is important not to make a decision about colostomy or primary operation before 24 h of life because significant intraluminal pressure is required for the meconium to be forced through a fistula orifice, which is the most reliable sign of the location of the fistula. If meconium is seen on the perineum, it is evidence of a perineal fistula. If there is meconium in the urine, a rectourinary fistula is present. © 2006 Springer-Verlag.

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