Abstract:
Objectives: To describe the anatomical sub-types of Anorectal malformations, their
management and the early outcome at Moi Teaching and Referral Hospital (MTRH)
over a 16 month period.
Design: A prospective study.
Setting: MTRH, in the neonatal Unit and paediatric surgical wards for the initial capture
of patients and initial follow up. The Paediatric Surgical out- patient clinic was used
for the subsequent follow ups.
Subjects: All infants diagnosed with ARM (Anorectal malformations) at MTRH from
November 2011 to April 2013.
Main outcome measures: Sub-types of the Anorectal malformations, coexisting
abnormalities morbidity and mortality rates.
Results: There were 42 participants including 24 (57%) males and 18 (43%) females.
Neonates presented at an average age of 4±3, three days and older children presented
on average age of 152±118, three days. There were 30 (71%) neonates and 12 (29%) older
infants. In males, the predominant sub-type was imperforate anus without a fistula
found in ten participants (42% of males). In females, the predominant sub-type was
recto-vestibular fistula found in 14 participants (78% of females). Mortality occurred
in 13 (31%) participants among them ten (24%) had coexisting abnormalities. The main
causes of morbidity were: colostomy complications in four (9.5%); wound infections
in one (5%); and wound dehiscence in one (5%).
Conclusions: Patients with Anorectal malformations presented late at MTRH. The
diagnosis at birth was missed in babies born at home as well as those delivered in
health institutions.
