1Associate Professor, Department of Orthopaedic, Muzaffarnagar Medical College, Muzaffarnagar
2Associate Professor, Department of Surgery, Muzaffarnagar Medical College, Muzaffarnagar
3Professor, Department of Surgery, J. N. Medical College, A.M.U., Aligarh
4Assistant Professor, Department of Surgery, King Faisal Medical College, Abha, Saudi Arabia
Anorectal malformations are relatively common congenital anomalies. The frequency of additional anomalies in patients with ARM ranges from 40% to 70%. Alterations of spinal cord are present in 13%-50% and are more frequent in lumbosacral spine. Sacral agenesis and failure of fusion of the posterior arch are the most common vertebral alteration. Malformations of sacral vertebrae might be associated with hypoplasia of levator ani muscle, functional deficiency of anal sphincter and damage of nerve roots. In this study we have evaluated the incidence of different types of associated spinal and urogenital anomalies and also the role of USG and MRI in their diagnosis.
All patients presenting with various types of anorectal malformations in our set up, from April 2008 to September 2010, were included in the study. Apart from routine investigations, invertogram and/or perineal ultrasonography, spinal anomalies were investigated in detail in all the patients.
Spinal anomalies were present in 21 (35%) out of 60 patients. Males were more likely to have spinal anomalies (40.5%) as compared to females (26.1%).
Detailed examination of the patient at the time of admission should be done to assess type of anorectal malformation and apparent associated anomalies. Every patient should be exhaustively evaluated to detect associated anomalies, which should be supported by appropriate investigations if required. Proper evaluation and management of these associated anomalies along with the management of anorectal malformation is crucial in achieving the goal of providing the patient a good quality of life.
Spinal Anomalies, Anorectal Malformation, Invertography, CT Scan, MRI
