Published online Jul 7, 2013. doi: 10.3748/wjg.v19.i25.3915
Revised: April 10, 2013
Accepted: April 17, 2013
Published online: July 7, 2013
Anorectal malformations (ARM) are common anomalies in neonates. Diagnostic and therapeutic delays in the management of ARM may lead to colonic perforation, and even death. Physical examination of the perineum is often sufficient to diagnose ARM in neonates. Notwithstanding, delayed diagnosis of ARM has become increasingly familiar to surgeons, as evidenced by the number of recent publications on this topic in the literature. In this commentary, we discuss spontaneous colonic perforation due to delayed diagnosis of ARM in neonates, and highlight the importance of early diagnosis in assuring good outcomes with surgical management. At this point, a thorough examination of the perineum during the initial newborn assessment is mandatory, particularly in those patients presenting with abdominal signs or symptoms.
Core tip: Anorectal malformations (ARM) are common anomalies observed in neonates. The delay in diagnosing a neonate with ARM results in significant complications, occasionally life-threatening morbidity, such as colon perforations. However, delayed diagnosis of ARM seems not the unique factor leading to colonic perforation, deficiency of musculature in the gut wall may also contribute. Colonic perforation due to ARM may not be avoided completely; however, early diagnosis is essential in assuring better outcomes with surgical management.