jsmc-10142

ANORECTAL MALFORMATIONS: A REVIEW OF 10-YEAR EXPERIENCE IN SULAIMANI (KURDISTAN REGION/IRAQ) PEDIATRIC SURGICAL CENTER  

Nian N. Ameen a and Ameer A. Ali b

a Department of Surgery, College of Medicine, University of Sulaimani. 

b Faruk Medical Group. 

  

Submitted: 13/8/2017; Accepted: 28/11/2017; Published 21/12/2017

DOI Link: https://doi.org/10.17656/jsmc.10142 

ABSTRACT

Background 

Anorectal Malformation (ARM) is a well recognized condition that involves congenital anomalies of the anus and rectum. It may present as a single or as a combination of abnormalities.

Objectives 

The aim of this study is to describe some epidemiologic data on anorectal malformation, estimating it’s prevalence in Sulaimani province, and characterizing the cases with regards to age at presentation, gender, pathological classification, associated anomalies, postoperative complication, and mortality rate.

Materials and Methods

This descriptive epidemiological study extended from Mach 2006 to March 2016, including all of patients presented with ARM in pediatric surgical unit at Sulaimani Teaching Hospital.

Results

The total cases were 194 patients (122 male and 72 females). 92% presented on the first week of life. 44.2% had associated anomalies. The prevalence rate is 6.4 cases per 10 000 live birth. Stomal complications are the most common post operative complication. The mortality rate is 8.24%. The relation between mortality and associated anomalies was statistically analyzed. 

Conclusion

The associated malformations rate and types are almost the same as in the literatures; however the prevalence rate was higher. This confirms the presence of geographic variation in ARM incidence, but could not confirm that the chemical attack or environmental impact of wars in this region had effects on increasing the rate of ARM due to lack of previous studies.

KEYWORDS

Anorectal Malformation (ARM), Imperforate anus (IA).

References 

1- Pena A. Imperforate anus and cloacal malformations. In: Holcomb GW, murphy PJ, Ostlie DJ, Editors . Aschraft’s pediatric surgery. 6thed. London: Saunders - Elsevier; 2015. P. 492-51.

2- Anorectal Malformation. In: Hutso JM, Brien MO, Beasley SW, Teague WJ, King SK, Editors. johne’s clinical paediatric surgery. 7thed. United Kingdom: WILY Black Well; 2015. P. 62-67.

3- Lunniss P, Nugent K .The Anus and Anal canal. In: Willians NS, Bulstrode ChJK, O’Connell PR, Editors. Bailey & love’s. 26th ed. Londo: CRC press; 2008. P. 1236-1260.

4-Makanga M , Ntirenganya F, Kaknade I. Anorectal malformations at University     Teaching Hospital of Butare in Rwanda: A review of 46 cases. East and Central African Journal of Surgery.2007; 12(2):110-115.            

5- Levitt MA, Bischoff A, Pena A. Anorectal Anomalies. In: Spitz L, Coran AG, Editors. Rob and Smith’s Operative Pediatric Surgery. 7th ed. UK: CRC Press; 2013. P. 496-522. 

6- Kella N, Saleh ABM, Qureshi GA. Urogenital anomalies associated with anorectal malformations in children .World Journal for Medical Sciences. 2006; 1(2):151-154.

7- Marc AL, and Alberto P. Anorectal malformations Orphanet Journal of Rare Diseases2007;2(33): https://doi.org/10.1186/1750-1172-2-33.

8- Jonker JE, Liem ET, Elzenga NJ, Molenbuur B, Trzpis M, Broens PM. Congenital Anorectal Malformation Severity Does Not Predict Severity of Congenital Heart Defects. The Journal of pediatrics. 2016; 179: 150-3.

9- Qazi SH, Faruque AV, Mateen Khan MA, Saleem U. Functional Outcome of Anorectal Malformations and Associated Anomalies in Era of Krickenbeck Classification. Journal of the College of Physicians and Surgeons--Pakistan. 2016; 26(3):204-7.

10- Bhargava P, Mahajan JK, Kumar A. Anorectal Malformation. Journal of Indian association of pediatric surgeons. 2006; 11(3):136-139. 

11- Rabea M. Laparoscopic-aided transanal pull-through procedure for the management of Hirschsprung’s disease: an observational prospective study for children older than 12 months. The Egyptian journal of surgery. 2016; 35(4): 348-356

12- Pena A, Levitt MA. Anorectal Malformations. In: Coran AG , Adzick NS, Krummel TM, Laberge JM, Caldamore A, Shamberger R. Pediatric Surgery.7thed. Philadelphia :Elsevier – Saunders; 2012. P. 128-130.

13-Murphy F, Pari P, Holschneider AM, Hutson JM .Incidence and frequency of different types, and classification of anorectal malformation. In: Holschneider AM, Hutson JM, Editors. Anorectal Malformation in Children. 1sted. Heldeberg: Springre-Verlag; 2006. P. 163.

14- Rintala RJ. Congenital anorectal malformations: anything new? Journal of pediatric gastroenterology and nutrition. 2009; 48:79-82.

15- Nitia IO. Mungadi IA, Agwu NP. Management of anorectal malformations in children: a 10-year experience in Sokoto, Nigeria. Sahel Medical Journal. 2007; 10(4): 128-131.

16- Levill MA, Pena A. Pediatric Colorectal Disorder. In: Beck DE, Roberts PL, Saclarides TT, Senagore AG, Editors. The ASCRS Text book of colon and rectal surgery. 2nded. New York: Springer; 2011. P. 825-830. 

17- Chavan R N, Chikkala B, Das C,  Biswas S,   Sarkar D K, and Pandey S K. Anorectal Malformation: Paediatric Problem Presenting in Adult .Case Reports in Surgery. 2015 ; Volume 2015, Article ID 625474, 4 pages.http://dx.doi.org/10.1155/2015/625474. 

18- Berger S, Gopp lM, Zacharion Z. Syndromology of Anorectal visited: from patterns of associated malformations to the recognition of syndromes .World Journal of pediatrics. 2005 ; 1: 8-14.

19- Mirshemirani A, Ghoroubi J, Kouranloo J, Sadeghiyan N. Spinal and vertebral Anomalies associated with Anorectal Malformation, Iranian Journal of Child Neurology. 2008. 

20- Kumar A, Agarwala S, Srinivas M, Bajpai M, Bhatnagar V, Gupta DK, et al. Anorectal malformations and their impact on survival. Indian journal ofpediatrics. 2005; 72(12):1039-42.

21- Huang CF, Lee HC, Yeung CY, Chan WT, Jiang CB, Sheu JC, et al. Constipation is a major complication after posterior sagittal anorectoplasty for anorectal malformations in children. Pediatrics and neonatology. 2012; 53(4):252-6.

22- Almaramhy HH. Incidence and spectrum of anorectal malformations in Western Saudi Arabia. Saudi medical journal. 2012; 33(12):1334-9.

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