scholarly journals Ectopic Ureter in Single System Kidney in Association with Anorectal Malformation in Male Patient

2020 ◽  
Author(s):  
Md Mokarram Ali ◽  
Amit Kumar ◽  
. Rashi ◽  
Amit Kumar Sinha ◽  
Bindey Kumar
Keyword(s):  
Male Patient ◽  
Anorectal Malformation ◽  
Anorectal Malformations ◽  
Male Child ◽  
Ectopic Ureter ◽  
Single System ◽  
Posterior Sagittal Anorectoplasty ◽  
Urogenital Abnormalities ◽  
Rare Association ◽  
Ectopic Ureters

Anorectal Malformations (ARM) are known to be associated with urogenital abnormalities. However, the incidence of ectopic ureter in these patients is rare. This report is about a two-year-old male child with ARM. The patient presented after a failed Posterior Sagittal Anorectoplasty (PSARP). The presenting complaint was urinary leak from rectum. Subsequently, the patient was taken up for redo-PSARP. During surgery, bilateral ectopic ureters were identified, incidentally. Surgeons operating on the patients of ARM should be vigilant about this rare association of ectopic ureter with ARM, so as to avoid its injury during perineal dissection.

scholarly journals The analysis of continence after posterosagital anorectoplasty in anorectal malformation patients in Wahidin Sudirohusodo hospital of Makassar

2019 ◽  
Vol 7 (6) ◽  
pp. 2022
Author(s):  
Alwi Lawile ◽  
Farid Nur Mantu ◽  
Nita Mariana ◽  
Arifin Seweng
Keyword(s):  
Gender Differences ◽  
Medical Records ◽  
Anorectal Malformation ◽  
Anorectal Malformations ◽  
Posterior Sagittal Anorectoplasty ◽  
Perineal Fistula ◽  
Cross Sectional ◽  
Cross Sectional Design ◽  
The One

Background: The management of anorectal malformations universally uses posterior sagittal anorectoplasty (PSARP) as standard surgery. The aim of this research was to determine continence in patients with anorectal malformation after PSARP action.Methods: This study was a descriptive analytical categorical research with cross sectional design. The data were obtained from patients’ medical records and questionnaire given to patients underwent PSARP in Wahidin Sudirohusodo Hospital and network hospitals from June 1 to December 1, 2018. The analysis was done to 60 children ranging from 5 to 8 years old. Most of them were male (56.7%) ranging from 5 to 6 years old (53.3%).Results: The results of the research indicated that based on malformation subtype, most of them suffered from rectourethra fistula (40.0%) with continence problem (61.7%). There was no significant correlation between sex and continence problem (p >0.05). However, it was seen that the percentage of continence subjects was higher in female (65.4%) than in male (58.8%), while the percentage of soiling and constipated subjects was higher in male than in female. Rectourethra fistula was found more frequently in male than in female (70.6%), while vestibuler fistula was found more frequently in female (69.2%). There was no significant correlation between age and defecation problem (p >0.05). However, the percentage of continence and soiling subjects was higher in 5-6 years children then the one for 7-8 year children, while the percentage of constipated subjects was higher in 7-8 year children (21.4%) than 5-8 year children (18.8%).Conclusions: Gender differences in the outcome of children with anorectal malformations must be considered. Men with perineal fistula were likely to experience continence and constipation than women with perineal fistulas. Women with perineal fistulas and vestibular fistulas had almost similar outcome.

scholarly journals Anorectal malformation with long perineal fistula: one of a special type

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sen Li ◽  
Jun Wang
Keyword(s):  
Anorectal Malformation ◽  
Bowel Function ◽  
Anorectal Malformations ◽  
Contrast Enema ◽  
Posterior Sagittal Anorectoplasty ◽  
Function Score ◽  
Perineal Fistula ◽  
Definitive Surgery ◽  
Inhibitory Reflex

AbstractThe anorectal malformation with long perineal fistula is a rare anomaly in the spectrum of anorectal malformations. Aim of the study is to describe the series of patients with anorectal malformation with long perineal fistula and compare the outcome with patient with standard perineal fistula. From March 2012 to January 2019, 7 patients who suffered from anorectal malformation with long perineal fistula were retrospectively reviewed. Three were operated on primarily by our department, and 4 cases were re-operated after a perineal anoplasty repair performed elsewhere. Four were operated by laparoscopy assisted anorectoplasty, and 3 cases were repaired by posterior sagittal anorectoplasty. The follow-up outcomes were compared with 71 cases of normal perineal fistula (NPF) in the same period. 7 cases have been followed up for 0.5–4 years (M = 2.57 ± 1.26) after definitive surgery. Their bowel function score was lower than normal perineal fistula (SPF = 12, range: 5–18; NPF = 18.5, range: 18–20). Four cases underwent anorectomanometry. The incidence of rectoanal inhibitory reflex was lower in the special type group. (p = 0.14). Three cases of contrast enema using barium: 2 cases of colorectal dilatation and thickening changes, 1 case showed no obvious abnormalities. Anorectal perineal fistula should be examined by distal colostogram at preoperation. This should be altered in: When suspecting a case of anorectal malformation type long perineal fistula a preoperative contrast enema could give insight of the anatomy befor performing a anoplasty.

scholarly journals LIMITATIONS OF CROSS TABLE PRONE LATERAL X-RAY/INVERTOGRAM IN DIAGNOSING OF TYPES OF ANORECTAL MALFORMATIONS

2020 ◽  
pp. 41-43
Author(s):  
Renu Kushwaha ◽  
Santosh Kushwaha ◽  
Rachna Bhatnagar ◽  
U.C Singh ◽  
Deepak Singh ◽  
...  
Keyword(s):  
Anorectal Malformation ◽  
Pediatric Surgery ◽  
Anorectal Malformations ◽  
Time Frame ◽  
Posterior Sagittal Anorectoplasty ◽  
Diagnostic Dilemma ◽  
X Ray ◽  
Medical College ◽  
Rectal Atresia ◽  
Anorectal Atresia

INTRODUCTION Anorectal malformation is the very common congenital malformation with the incidence of 1 in 5000 (1,2). The diagnosis is made on perineal examination which is further corroborated by cross table prone lateral x-ray or invertogram to find out the level of anorectal atresia. The cross table prone lateral x-ray is considered better investigation tool as compared to invertogram for demonstration of the level of rectal atresia in neonates. In prone cross table lateral x-ray, effect of gravity is negated, positioning of the baby is more comfortable and the rectal gas shadow is better delineated. AIM To evaluate the sensitivity and specificity of cross table prone lateral x-ray in labelling a patient of anorectal malformation as high or low. MATERIAL AND METHODS The study was conducted in retrospective manner. Radiological materials, clinical and operative records of the neonates with anorectal malformation operated in Department of Surgery, Pediatric Surgery unit, BRD Medical College over a period of 2 years (June 2017 to July 2019) were retrieved. Total 100 neonates with anorectal malformation were admitted in our hospital during this time frame. Out of these patients, colostomy was done in 79 patients, anoplasty was performed in 18 cases. Two patients underwent primary posterior sagittal anorectoplasty while 1 patient had ileostomy done. During this study, we came across four unusual cases of low anorectal malformation where the x-ray picture did not coincide with the clinical diagnosis. CONCLUSION Diagnosis of anorectal malformation is clinical but to diagnose the type of anorectal malformation it requires both clinical as well as radiological workup. In case of diagnostic dilemma, our clinical interpretation should lead the diagnosis as none of the x-ray modality has 100% sensitivity.

scholarly journals Congenital ureterovaginal fistula: a rare case of single-system ectopic ureter with ipsilateral ectopic kidney managed by vaginal approach: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Demisew Amenu ◽  
Andebet Asmare ◽  
Ahmed Siraj
Keyword(s):  
Ectopic Ureter ◽  
Pelvic Kidney ◽  
Single System ◽  
Ectopic Kidney ◽  
Ureterovaginal Fistula ◽  
Duplex Kidney ◽  
Case Presentation ◽  
Ectopic Ureters ◽  
Continence Rate

Abstract Background Diagnosing urinary incontinence from organic causes such as ectopic ureter is particularly important because of the potential for cure by surgical correction. The prevalence of ectopic ureter is uncertain because many are asymptomatic and the diagnosis is usually overlooked. Eighty percent of ectopic ureters in females are often associated with duplex kidney. However, an ectopic ureter draining a single-system ectopic dysplastic/atrophic but functioning kidney is rare, especially in females. The overall long-term continence rate after successful correction of ectopic ureter is satisfactory. Case presentation This case is reported to highlight a rare situation, where a 22-year-old nulligravid Ethiopian women presented with a complaint of continuous wetting of her underwear since childhood, but she had normal voiding pattern. Localized right pelvic kidney ultrasound and computed tomography scan with contrast revealed right ectopic ureter and atrophied ipsilateral pelvic kidney with good function. Surgical reimplantation through vaginal approach was performed, and the outcome was good. The patient’s subsequent follow-ups were uneventful. Conclusion An extramural vaginal ectopic ureter is better accessed through transvaginal approach than abdominal, especially when it is associated with pelvic ectopic kidney. This modified approach is less invasive and has lower morbidity and better success rate than a transabdominal approach.

scholarly journals Role of Routine Dilatations after Anorectal Reconstruction—Comparison of Two Tertiary Centers

2018 ◽  
Vol 29 (03) ◽  
pp. 243-246 ◽  
Author(s):  
Dhanya Mullassery ◽  
Sumita Chhabra ◽  
Ashik Babu ◽  
Roberta Iacona ◽  
Simon Blackburn ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Surgical Outcomes ◽  
Anorectal Malformations ◽  
Postoperative Management ◽  
Posterior Sagittal Anorectoplasty ◽  
Anorectal Reconstruction ◽  
Definitive Surgery ◽  
The Uk

Aim Regular anal dilatations are commonly recommended in the postoperative management following posterior sagittal anorectoplasty (PSARP) in anorectal malformations (ARM). We hypothesized that routine postoperative dilatations may not affect surgical outcomes following PSARP. We compare surgical outcomes of routine postoperative dilatations versus no routine postoperative dilatations from two United Kingdom tertiary pediatric surgical centers. Materials and Methods This is retrospective records review of patients undergoing definitive surgery for ARM in two tertiary surgical centers in the UK over 5 years. Center A used a protocol of routine postoperative dilatations, and center B used a protocol, which used dilatations only for clinical indications of stricture. Data collected included ARM type, operative procedures, and postoperative interventions. All post-operative interventions under general anesthesia (GA) were compared between groups. Results From 2011 to 2015, 49 procedures (46 PSARPs) were performed in center A and 54 (52 PSARPs) in center B. Median follow up period was 31 months (interquartile range [IQR] 18–48). The first postoperative anal calibration under GA was documented for 43 (86%) patients in center A and for 42 (78%) patients in center B. Following this, center A followed routine postoperative dilatation (RPD) at home, and center B reserved further dilatations for specific indications. RPD was performed for 100% of patients in center A versus 8% in center B. Further anal dilatations under GA were performed in 19 (38%) children in center A and in 17 (34%) children in center B (p = 0.68). In center A, 10 patients (22%) needed further surgery versus 14 (28%) in center B (p = 0.48). Conclusion The use of routine postoperative dilatations does not significantly improve surgical outcomes following PSARP in ARM.

Duplication cyst with midgut volvulus in a neonate: an unusual presentation

2020 ◽  
Vol 13 (8) ◽  
pp. e235526
Author(s):  
Nitin G Pai ◽  
Santosh Prabhu ◽  
Pavithra Prabhakar ◽  
Vijay Kumar
Keyword(s):  
Surgical Intervention ◽  
Case Reports ◽  
Anorectal Malformations ◽  
Duplication Cyst ◽  
Midgut Volvulus ◽  
Rare Association ◽  
Internal Hernias ◽  
Gastrointestinal Duplication Cyst ◽  
Resection And Anastomosis ◽  
Gastrointestinal Duplication

Incomplete intestinal fixation or malrotation of gut with midgut volvulus is one of the important causes of bilious vomiting in neonates. The incidence of malrotation of gut in population is 4% and that of duplication cyst is 1:4500. Patients with malrotation are prone to develop midgut volvulus due to their narrow mesenteric base demanding urgent surgical intervention. Common associated anomalies are intrinsic duodenal obstruction, internal hernias, caecal volvulus, anorectal malformations and Hirschsprung’s disease. The present case refers to a 4-day-old neonate who presented with malrotation of gut with reverse volvulus and an associated gastrointestinal duplication cyst, which is a rare association with only few reported case reports. After imaging with ultrasound and contrast radiograph, the baby underwent prompt surgical intervention in the form of Ladd’s procedure with resection and anastomosis of jejunal duplication cyst.

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