Anorectal Malformations

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An eighteen month old infant presents with difficulty passing stools. A grandfather and cousin reportedly required some type of bowel surgery in childhood. Digital rectal exam shows a somewhat narrowed but normally positioned anus. A computerized tomography scan is obtained that identifies a presacral mass. The next step in management in this patient with constipation is [size=20px]A serum alpha fetoprotein B barium enema C magnetic resonance imaging of the spine D suction rectal biopsy E colonoscopy​​[/size]

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A newborn female, diagnosed at birth with cloaca without hydrocolpos, hydronephrosis or other associated malformation undergoes a proximal sigmoid colostomy and mucous fistula. At 6 months of age, she undergoes cystovaginoscopy and 3D fluoroscopic assessment of the cloaca which reveals a 1.5 cm common channel and a 2 cm urethra. Based on current recommendations, the most appropriate reconstruction for this patient would be: A Vaginoplasty, introitoplasty and posterior sagittal anorectoplasty (PSARP) B Total urogenital mobilization (TUM) and PSARP C Laparoscopic TUM and PSARP D Urogenital separation (UGS) and PSARP E Anterior sagittal anorectoplasty​

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An infant in the delivery room presents with the following anorectal abnormality. The best next step for this perineal finding is [size=20px]A observation B topic estrogen C serial dilations D local excision E diverting ostomy[/size]

please write the answer and your justification, correct answer will be submitted after 48 hrs [size=20px]A 4 month female with anal stenosis presents for routine follow up. She has been serially dilated to a 13 Hegar, although symptoms of constipation persist. A Voiding cystourethrography (VCUG), renal ultrasound, spinal ultrasound, and ECHO in the NICU were normal. The next step in management would include: A No additional evaluation required B Anal manometry C Suction rectal biopsy D Open rectal biopsy E MRI of pelvis[/size]

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[size=20px]A 5-year-old male with a history of a previously repaired rectobulbar fistula presents for evaluation of severe constipation and fecal incontinence over the last year. On examination, the child is noted to have an adequately sized anus located within the sphincter complex. There is no stricture or prolapse. The sacrum and spine are normal. The child is currently managed successfully with rectal enemas, although his parents state the child is becoming less cooperative with enemas and they would like to discuss an antegrade option. He had several urinary tract infections in infancy but has not had any in nearly 3 years. He remains diapered and has several wet dia…

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