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Anorectal malformation

Anorectal malformation (ARM) is associated with a tethered spinal cord (TSC).

Case series


Patients aged 7 years and older who underwent repair of ARM and spinal magnetic resonance imaging from January 1995 to December 2008 were reviewed retrospectively. Untethering surgery was performed in all patients who were diagnosed with TSC, regardless of the presence or of neurological symptoms. Clinical symptoms reflecting anorectal, urinary, and lower limb function were compared between patients complicated with TSC (TSC group, n = 17) and those without TSC (non-TSC group, n = 14).

The median age at functional evaluation was 11.7 and 12.9 years in the TSC and non-TSC groups, respectively (p = 0.52). Untethering surgery for TSC was performed at a median age of 1.3 years. Preoperative urinary and lower limb dysfunction, except for vesicoureteral reflux in the TSC group in one patient, was improved after surgical detethering. Current anorectal function was comparable between the groups.

Long-term functional outcome in patients with ARM and TSC undergoing untethering surgery is equivalent to that in those without TSC. Prophylactic surgical detethering for patients with ARM and TSC can be a treatment of choice to maximize neurological functional outcome 1).

Tethered Cord and Anorectal Malformations: A Case Series 2).

Case reports

A 3-day-old male neonate presented with features of anorectal malformation and duplication of the external genitalia. He was subsequently diagnosed with complete duplication of the colon, rectum, bladder, and urethra associated with spinal lipoma 3).

Inoue M, Uchida K, Otake K, Nagano Y, Shimura T, Hashimoto K, Matsushita K, Koike Y, Matsubara T, Kusunoki M. Long-term functional outcome after untethering surgery for a tethered spinal cord in patients with anorectal malformations. Pediatr Surg Int. 2017 Aug 4. doi: 10.1007/s00383-017-4127-y. [Epub ahead of print] PubMed PMID: 28779274.
Destro F, Canazza L, Meroni M, Selvaggio G, Parazzini C, Valentini L, Riccipetitoni G. Tethered Cord and Anorectal Malformations: A Case Series. Eur J Pediatr Surg. 2017 Sep 25. doi: 10.1055/s-0037-1606844. [Epub ahead of print] PubMed PMID: 28946162.
Swaika S, Basu S, Bhadra RC, Sarkar R, Maitra SK. Caudal duplication syndrome-report of a case and review of literature. Indian J Surg. 2013 Jun;75(Suppl 1):484-7. doi: 10.1007/s12262-013-0838-z. PubMed PMID: 24426655; PubMed Central PMCID: PMC3693374.
anorectal_malformation.txt · Last modified: 2017/09/26 22:41 by administrador