The role of ultrasonography in detecting and classifying anorectal malformations in neonates: a retrospective study of 30 cases.

Abstract

Background: Anorectal Malformations, a common congenital anomaly of the gastrointestinal tract, is caused by the defect or delay of hindgut development in the embryo.

Objectives: This retrospective study aimed to analyze the ultrasonographic and clinical features of 30 neonates with anorectal malformations to provide guidance for clinical diagnosis and treatment.

Material and methods: We selected 30 neonates with congenital anorectal malformations admitted to our hospital from January 2012 to June 2022. Each neonate underwent two-dimensional ultrasonography and lateral plain X-ray of the abdomen within 24 h before surgery, and we assessed the typical manifestations of anorectal malformations, categorized the cases into high, intermediate, and low types, and evaluated the incidence of anorectal malformations associated with other organ malformations. Comparisons were made between the three types of anorectal malformations in terms of associated anomalies.

Results: Among the 30 neonates, typical manifestations of anorectal malformations were observed in all cases. Ultrasonographic evaluation revealed 6 cases of high anorectal malformations, 11 cases of intermediate anorectal malformations, and 13 cases of low anorectal malformations. The distribution of fistula types included 3 cases of perineal fistula, 2 cases of rectourethral fistula, 23 cases without fistula, and 2 cases of anorectal malformations. Additionally, congenital cardiac structural malformations were identified in 3.3% of the cases. Post-surgical outcomes indicated that 25 neonates were successfully cured and discharged, while 5 neonates experienced rectal retraction. The age at the time of the complete surgical correction (i.e., PSARP) ranged from 3 to 6 months for intermediate and high anal atresias. Notably, 5 neonates experienced rectal retraction post-surgery, which was successfully managed before discharge. Postoperative complications, such as incision infection, blood oozing, urinary extravasation, and fistula stenosis, were reported in 14 neonates.

Conclusions: Infants with congenital anorectal malformations commonly present with abdominal distension, vomiting, and absence of meconium excretion, indicative of intestinal obstruction. Given the high mortality risk associated with anorectal malformations, early diagnosis and intervention are crucial. Effective communication between healthcare providers and patients' families enhances treatment success. Ultrasonography plays a significant role in the early diagnosis of anorectal malformations.