Imperforate Anus, Newborn

The anus is the opening of the buttocks where stool leaves the body. Imperforate anus is a problem that babies are born with (a congenital condition) in which the anus is missing, blocked, or in the wrong place. This condition can cause stool to back up in the large intestine or leave the body through another opening. This condition is treated with surgery.

Imperforate anus is also called anorectal malformation.

What are the causes?

The exact cause of this condition is not known. However, it is sometimes associated with other conditions that babies are born with.

What are the signs or symptoms?

Symptoms of this condition include:

No visible anus.
A swollen abdomen.
No stool during the first days of life.
Stool that comes out with urine from the tip of the penis, in boys.
Stool comes out through the opening of the vagina, in girls.

How is this diagnosed?

This condition is diagnosed based on a physical exam and tests. Tests may include X-rays of the abdomen, an ultrasound, or an MRI.

How is this treated?

Treatment right after birth

After birth, your baby will need to be transferred to an intensive care unit (NICU) for initial treatment and more evaluation to determine a plan. Immediate treatment for your baby may include:

Stopping feedings. However, if you plan to provide your baby with breast milk, you should begin a breast pumping schedule right away. This will help establish and maintain a milk supply. You may freeze this pumped breast milk to use later.
Inserting a tube in your baby's nose or mouth that goes into the stomach. This would be connected to a suction device that would take out air and fluid from the stomach.
Inserting an IV into one of your baby's veins. This is how your baby will get fluid, nutrition, and medicines such as antibiotics.
Having imaging tests to look for other problems that are often associated with this condition.

Later treatment

This condition is treated with surgery to create a normal rectum and anus (perineal anoplasty). Surgery involves creating an opening where the anus should be and closing any openings that are in the wrong place. Often, more than one surgery is needed. Surgery is usually successful. However, some children may have lifelong difficulty with constipation or controlling bowel movements (bowel incontinence) after surgery. A bowel management program is helpful in these cases.

In some cases, a procedure may be done to create a temporary opening for stool to leave the body (colostomy). The opening allows stool to collect in a bag outside of the body. Colostomy may be done if reconstructive surgery cannot be done right away. After reconstructive surgery, the opening will be closed off. Treatment for imperforate anus depends on the severity of the condition and would take place at a hospital that specializes in treating babies with this condition.

Summary

Imperforate anus is a condition in which the anus is missing, blocked, or in the wrong place.
This exact cause of this condition is not known. It is sometimes associated with other conditions that babies are born with.
After birth, your baby will need to be transferred to an intensive care unit (NICU) for treatment and tests.
This condition is treated with surgery to create a normal rectum and anus.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.