How A Baby Born With No Anal Opening Was Successfully Treated After Multiple Surgeries

The child, now one-year-old, has been able to achieve all developmental milestones. According to the doctors, treating him at the right time with appropriate surgeries made all the difference.

A one-year-old infant with a rare congenital condition called anorectal malformation (ARM) -- meaning, the baby had no anal opening -- was recently treated successfully after undergoing a series of operations. After the birth of the baby, he had five surgeries -- namely colostomy, anal reconstruction, and colostomy closure to address issues of ARM, along with other issues like hypospadias and tongue tie. Despite these challenges, the baby is now reaching developmental milestones appropriate for his age. Scroll down to find out more about this case.

The Health Problems

Shortly after the birth of the baby, his parents were informed that the newborn had a congenital condition called anorectal malformation, which resulted in the absence of an anal opening. The baby also had other problems like hypospadias, which means the male reproductive part was bent and the opening of the urinary hole was not in place. He was admitted in the neonatal intensive care unit (NICU) at Wockhardt Hospitals, Mira Road, and initiated on parenteral nutrition (feeding intravenously through a vein) since breastfeeding was not possible.

A medical team comprising Dr Bhavesh Doshi, consultant pediatric surgeon and Dr Nitu Mundhra, neonatologist were assigned to the case.

What Is ARM?

Dr Mundhra, a consultant neonatologist and lactation expert said ARM is rare, and often comes as a 'shock' to parents, since it may not always be diagnosed during antenatal scans. "In the delivery room, all the babies are examined from head-to-toe for abnormalities. So, like this baby had anal malformation, we immediately looked for other abnormalities in the delivery room. He also had bent [male genitalia] along with an abnormal position for urinary meatus (hypospadias), and a tongue tie -- a condition where the tongue is attached to the floor of the mouth; it is not possible to protrude the tongue, leading to breastfeeding problems and speech difficulties. After appropriate counselling of parents, the baby underwent multiple surgeries," the doctor said.

A Step-By-Step Breakdown Of The Treatment

Dr Doshi added that the complete treatment of anorectal malformation was done in three surgical steps. "At birth, a colostomy was done. In this problem, we have to make a temporary opening (making a bypass passage for stool, so that the baby can be started on feed). At two months of age, a four-hour-long surgery of posterior sagittal ano rectoplasty (PSARP) was performed where the new anus was created at the normal position. Two months after the second surgery, the child underwent a final surgery for ARM, colostomy closure. During the surgery, the opening, which was created in the abdominal wall, was closed. The child now passes stool normally."

The doctor further said that at one year of age, the child had to undergo a major surgery for correcting the bent-over genitalia and get the urinary opening to the normal position. "After a three-hour long surgery, the child passed urine from the normal position."

The child, now one-year-old, has been able to achieve all developmental milestones. According to the doctors, treating him at the right time with appropriate surgeries made all the difference.