Congenital anomalies associated with anorectal malformations – 16-year experience of one surgeon

Introduction: A retrospective study of 109 children with anorectal malformations (ARMs) was performed to find the incidence of associated congenital anomalies.
Material and methods: 109 consecutive children with ARMs were treated between 1992 and 2008. Analysis included sex, duration of pregnancy, body weight at birth and APGAR score, type of ARM and any associated anomalies. Anorectal malformation was classified according to Pen~a as either high, low or complex defect. All associated anomalies were classified in ten categories: urological, vertebral (incl. sacral bone), other skeletal, central nervous system, tracheoesophageal, cardiovascular, genital, gastrointestinal, miscellaneous and chromosomal abnormalities.
Results: The incidence of ARMs in this series was approximately 1 in 2300 live births. Additional anomalies were found in 66% of infants with ARMs. The most common associated defects were urinary tract (38.5%) and vertebral anomalies (33.9%). Trisomy 21 was observed in 3 children (2.8%). Multiple (two or more) associated anomalies were found in 40 out of 72 children with defects coexisting with ARMs (55.5%). VATER complex was observed in 13 children.
Conclusions: Children with ARMs have a high incidence of associated congenital anomalies. Neonates born with ARMs should be evaluated in search of anomalies of other organs and systems, because these additional defects are responsible for morbidity and mortality in patients with anorectal malformations.