Department of Surgery, College of Medicine, University of Mosul, Mosul, Iraq.
Department of Pediatric Surgery, Al-Khansaa Teaching Hospital, Mosul, Iraq.
Document Type : Research Paper
Background: Anorectal malformations (ARMs) include a wide spectrum of diseases affecting male and female neonates and involve the rectum, anal canal, and genitourinary tract.
Objective: To know the actual incidence of anorectal malformations in Mosul city, upgrade clinical knowledge about ARMs between health workers and midwives who look after newborn babies, and assess the related mortality in the limited resources zone.
Method: A closed cohort study was conducted on patients with ARMs admitted to the pediatric surgery centre between January 2018 and January 2019. Patients included in this study are those with ARMs in the neonatal period, those admitted for pull-through or closure colostomy. We excluded from this study any Patients born before 2018 or those not operated.
Results: sixty-two patients were included in this study with a Male: female ratio of 1.3:1. The estimated incidence was 4 per 5000 live birth. Twenty-eight (45.2%) patients presented after 48 hours of birth (Delayed diagnosis), with a median age at diagnosis of two days. Twenty-five (40.3%) from a total of 60 operated patients had associated congenital anomalies. Forty-three (69.3%) patients had colostomy (mainly transverse colostomy), with some cases have completed their three-stage procedure. Mortality was recorded in 5 (8%) cases ( four males and one female, with major congenital anomalies).
Conclusion: ARMs represent one of the stressful GIT anomalies to pediatric surgeons. The overall outcome is greatly influenced by age at diagnosis, surgical experience, and associated anomalies. The major subtypes that need three stages surgeries require great efforts and more hospital resources. We recommend the need for widespread teaching programs for midwives and health workers to diagnose and refer ARMs cases to the tertiary centres as soon as possible to minimize complications and hopping lessen the mortality rate.
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