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Neonatal Rectal Perforation: Rare Complication of Congenital Anal Stenosis (Abstract)

Abdul Rauf Khan, Atif Saeed, Hamza Iltaf Malik, Adil Aslam,
Department of Paediatric Surgery
Cambridge University Hospitals NHS Foundation Trust
Addenbrooke’s Hospital, United Kingdom



Congenital anal stenosis, although quite common in neonates, can be easily missed with serious consequences for the child. Although classed as a minor anomaly, if neglected, becomes a major one requiring urgent surgical treatment. We present a case of rectal perforation secondary to anal stenosis in an apparently normal looking anus. A 2-day-old 3.5 kg male neonate presented with a 24-hour history of poor feeding and abdominal distension. Abdominal radiographs revealed pneumoperitoneum. At laparotomy, a full-thickness perforation of the anterior wall of rectum above the peritoneal reflection was found, which was repaired and anal dilatation with a sigmoid loop colostomy performed. Rectal biopsy was normal. The colostomy was reversed 6 weeks later. Subsequently, postoperative recovery was uneventful and bowel habit was normal. It is therefore recommended that neonates with signs of low intestinal obstruction should have per rectal examination even in the presence of normal looking anus and should be monitored closely.

key words: rectal perforation, congenital anal stenosis



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