Imperforate anus

Case contributed by Dr Chitani Mbewe

Presentation

2 day-old of neonate with distended abdomen

Patient Data

Gender: Male
X-ray

Abnormal bowel loop gaseous distension. 

Horizontal lateral shoot through imaging performed to determine the position of the most distal portion of the rectum and establish whether it is a high or low anal atresia.

No vertebral body abnormalities.

Ultrasound

No associated spinal cord abnormalities. 

Case Discussion

The frontal abdominal radiograph demonstrates abnormal gases distension of the bowel loops.

Accompanying lateral horizontal shoot through image is utilized to establish the extent of defect in the anal or rectal atresia.  The anus is marked with radio dense marker and the baby is placed in prone position.  The resultant lateral radiograph shows gas within the distended rectum, rising to the highest point and indicating the degree of the atresia.

No abnormalities of the spinal cord were identified on neonatal ultrasound of the spine. A radio dense marker was placed over the skin at a level corresponding to the termination of the cord. Follow-up spine radiograph (with radio dense marker in situ) showed no vertebral abnormalities, which may be common in cases of anal atresia.

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