What are the symptoms and treatment of anal atresia?

Anal atresia is a physical defect. The main cause of its formation is congenital fission and deformity caused by poor development during embryonic development. Patients with anal atresia cannot defecate normally. There is no gap in the anus and it cannot be connected to the rectum, so the rectum will be poorly developed. Most patients with anal atresia are male and the exact cause cannot be found. Surgery is needed in the early stages to relieve it. As parents, they should also have relevant understanding and attention to complications. Although anal atresia is relatively rare at present, the incidence rate is about 50%, so it is necessary to judge by physical characteristics and choose the appropriate method of treatment.

Symptoms and signs

No meconium is discharged after birth, the anal area is covered with skin, there is a sense of impact in the anal area when crying, and on the inverted lateral X-ray film, the end of the rectum is located at the pubic line or slightly below it. Ultrasound and puncture methods measure that the blind end of the rectum is about 1.5 cm away from the skin of the anal area.

After birth, the child had no meconium excretion and soon developed vomiting, abdominal distension and other symptoms of intestinal obstruction. Local examination showed that the center of the perineum was flat and the anal area was partially covered with skin. In some cases, there was a small depression with obvious pigmentation and radiating wrinkles. Circular muscle contraction reaction could be seen when stimulated. When the baby cried or held his breath, there was a protrusion in the center of the perineum. Placing fingers in this area could feel an impact. When the baby was placed in a high-hips and low-head position, percussion at the anus produced a tympanic sound.

Treatment

prevention:

Early detection, early diagnosis and early treatment can prevent the occurrence of complications. Western medicine treatment of anal atresia

Surgical treatment:

After the diagnosis is confirmed, surgical treatment should be performed sooner or later. Generally, perineal anal plasty is performed, and sacroperineal anal plasty can also be used.

Perineal anoplasty:

⑴Incision

⑵Separation through the middle of the sphincter

⑶ Free rectal blind end

⑷ Anal formation

Perineoplasty

(I) Incision: Make an X-shaped incision about 1.5 cm long in the center of the perineum or in the middle of the stimulable annular contraction zone. The skin was incised and 4 skin flaps were turned over, and the external circular sphincter fibers were visible underneath.

(ii) Find the free blind end of the rectum: Use an ant-type vascular forceps to bluntly separate the soft tissue from the middle of the sphincter to the deep layer. The blue blind end of the rectum can be found, and two thick silk threads are passed through the muscle layer of the blind end for traction. Because the blind end of the rectum is located within the puborectal muscle ring, it should be separated upwards close to the intestinal wall. The blind end is freed for about 3 cm so that the rectum can be pulled loosely to the anus. The rectum must be freed to a sufficient length. If it is not fully freed and the suture is pulled down forcibly, the intestinal wall will easily retract after the operation, causing scar stenosis. During separation, damage to the urethra, vagina and rectal walls should be avoided.

(III) Rectal incision: Make a cross-shaped incision at the blind end of the rectum and use a suction device to suck out the meconium, or let it flow out naturally and wipe it clean. Pay attention to protecting the wound surface and try to avoid contamination. If contamination occurs, rinse carefully with saline.

(IV) Anastomosis and fixation: Fix the blind end of the rectum to the surrounding soft tissue with several stitches, and use thin silk thread or intestinal thread to intermittently suture the intestinal wall and the perianal skin with 8 to 12 stitches. Note that the intestinal wall and skin flap should be cross-matched so that the scar is not on the same plane after healing. Anal dilation begins about 10 days after surgery to prevent anal stenosis.