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]

C.

this is an anterior transposed anus with incopetent posterior forchet.

I think serial dilatation is a wise deciosin at time. Later on at the age of 6-12 month an elective PSARP can be done without colostomy

C

A

correct answer

A observation

 

The patient has a perineal groove, an abnormality posterior to the junction of the labia majora just distal to the vestibule. The lesion looks like a slit of mucosa and is classified as complete or incomplete depending on whether the mucosa encompasses the entire length of the perineal raphe from the vestibule to the anal opening. With a perineal groove there is normal formation of the vestibule including the urethra and vagina. There is also typically hypertrophy of the tissue skirting the perineum and coursing posteriorly to join the anus.

 

The differential diagnosis includes ulcerated hemangioma, lichen sclerosis, perianal pyramidal protrusion, and trauma or abuse.

 

The natural history of perineal groove is slow epithelialization. Rarely, it is shown to be associated with urinary tract infections and/or perineal irritation and inflammation. If asymptomatic, the parents should be reassured for a prolonged natural epithelialization. If symptomatic, local excision and primary closure may be performed. (MA)

This superficial perineal groove just followup