Congenital and Pediatric Anorectal Conditions

Abstract

Congenital pediatric anorectal problems include anorectal malformations and Hirschsprung’s disease. Anorectal malformations are diverse, often associated with other anomalies including genitourinary or sacral ones. Repair may be staged and is generally completed with a posterior sagittal anorectoplasty. Hirschsprung’s disease may present gradually with constipation or acutely with enterocolitis, requiring either a pullthrough procedure, or occasionally a colostomy. Among other anorectal anomalies, treatment of fistula-in-ano, anal fissure and rectal prolapse may be nonoperative in pediatric patients, or a procedure similar to that done in adults. Another important consideration is that of sexual abuse, as there are important anal signs of abuse.