A single centre study of anomalies associated with anorectal alformations

Background: Anorectal malformations (ARM) are frequently accompanied by other congenital anomalies. The aim of the study was to compare occurrence of associated anomalies in patients with anorectal malformations and classify the subjects according to Krickenbeck’s classification of anorectal malformations. Methods: An observational retrospective study in 2020-21 was conducted in the Department of Pediatric Surgery at Lokmanya Tilak Municipal Medical college and Municipal Hospital, Sion, India. The study was approved by the institutional ethics committee. 90 patients including newborns upto the age of 12 years diagnosed with anorectal malformations were considered in the study. Patients were stratified according to the Krickenbeck’s classification of anorectal malformations. The associated anomalies with anorectal malformations were cardiovascular, genital, urinary, respiratory, gastrointestinal, central nervous system and skeletal. Results: We assessed 90 patients; 59% patients were males. 77% patients with anorectal malformation had at least one other associated anomaly. The most common types of anorectal malformations in the present study, according to Krickenbeck’s classification were rectovestibular and rectovesical fistulae. The urinary system anomalies such as vesicoureteric reflux and renal agenesis followed by cardiovascular system anomalies such as atrial septal defect were the most common anomalies associated with anorectal malformations. 43% patients had urinary system anomalies; 38% had cardiovascular anomalies; 10% had gastrointestinal system anomalies; 12% had genital system anomalies; 24 % had central nervous system anomalies and 4% patients had skeletal anomalies associated with anorectal malformations respectively.10% patients with anorectal malformations had associated VACTERL syndrome. Conclusion: The incidences of many associated anomalies with anorectal alformations in our study were higher than those compared with the earlier studies. A detailed physical, systemic and radiological examination along with multidisciplinary approach is required in all patients with anorectal malformation. Genetic counselling may be necessary in complex cases