Presentation
Imperforate anus with abdominal distension.
Patient Data

Evidence of nasogastric tube with its tip in the stomach. Normal cardiomedistinal contour. The lungs are clear. No pleural effusion bilaterally. No abnormal bowel dilatation. No intramural air. No pneumoperitoneum. No osseous abnormality.

Evidence of nasogastric tube with its tip in the stomach. Normal cardiomedistinal contour. The lungs are clear. No pleural effusion bilaterally. Dilated large bowel loops, predominantly the rectum and sigmoid colon. The small bowel loops are not dilated. There is no intramural air. There is a noted absence of gas shadows in the pelvis. No pneumoperitoneum. No osseous abnormality.
Case Discussion
Plain X-ray features are suggestive of an anorectal malformation that was confirmed clinically.
The patient underwent stoma creation for faecal diversion while awaiting definitive surgery.
Ultrasound of the renal tract and spine is recommended to assess for associated renal and spinal abnormalities 1.
Fluoroscopy is helpful to look for the fistula. The fistula can be either a low type (below the pubococcygeal line) or a high type (above the pubococcygeal line).
Co-author: Tan Shung Ken