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Anal atresia
Last reviewed: 07.07.2025
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Anal atresia is an imperforate anus.
There is also often a fistula from the blind sac of the rectum that opens into the perineum or into the urethra in boys and into the vagina or vestibule of the vagina or rarely the bladder in girls. The blind anus and the skin of the perineum may be separated by a few centimeters or separated only by a thin membrane of skin covering the anal orifice.
Anal atresia is obvious on routine physical examination of a newborn because the anal opening is absent. If the diagnosis is not made and the child is fed enterally, he or she soon develops signs of low bowel obstruction.
Urine should be collected and examined for meconium, which indicates an opening of the fistula into the urinary tract. Plain radiography and fistulography with the child in the prone position in the lateral projection can determine the level of the lesion. A cutaneous fistula usually indicates low atresia. In such cases, radical treatment using a perineal approach is possible. If there is no fistula to the perineum, a high lesion is likely.
Radical treatment is usually postponed until the child reaches a certain age, when the structures to be repaired are larger. Until then, a colostomy should be created to eliminate the obstruction.
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