Underdiagnosis of Mild Congenital Anorectal Malformations.


eMediNexus    23 January 2018

The aim of a study published in The Journal of Pediatrics was to determine whether the frequency and severity of congenital anorectal malformations (CARMs) differ by sex. This study enrolled 129, 0-319 week olds diagnosed with CARMs, who had been referred to the Department of Pediatric Surgery, between 2004 and 2013. Here, rectoperineal and rectovestibular fistulas were classified as mild CARMs, while all others as severe. The results showed that 58% girls and 42% boys were diagnosed with different forms of CARM. A higher number of patients had mild rather than severe forms of CARM (67% and 33%, respectively). While 89% of girls had a mild form of CARM, 65% of boys had severe forms. In addition, all severe forms were diagnosed early, whereas 54% mild forms were diagnosed early and 46% were diagnosed late. Hence, it was inferred that mild forms of CARM are more frequent in girls, whereas severe forms are more common in boys. Whereas, the overall distribution across the sexes is equal. It was stated that since chronic constipation can be the only symptom of mild CARMs, it often requires more time to diagnose than severe forms. Thus, many women are diagnosed with CARMs at an older age or remain undiagnosed. Consequently, these women are at a greater risk of full rupture during vaginal delivery.

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