Anorectal Anomalies In Ghana – A Review Of 54 Cases

Abstract

Background: Anorectal anomalies are common paediatric problems, but represent surgical challenges. Our experience in the management of anorectal anomalies in children seen at the Paediatric Surgery Unit of the Korle-Bu Teaching Hospital, Ghana, is presented.
Patients and Methods: This was a retrospective review of children with anorectal malformation seen at the Paediatric Surgery Unit of the Korle-Bu Teaching Hospital from February 1998 to December 2005.
The parameters reviewed were age and sex profiles, the type of anomaly, the presence or otherwise of a fistula, associated anomalies, the number of surgeries done and an assessment of progress, complications and eventual outcome in terms of continence made at the last follow-up visit .
Results: There were 54 patients, 36 were males and 18 were females (M:F=2:1). Presentation in the neonatal period was the most common. Age at presentation ranged from one day to 51/2 years, with a mean of 3 months. Twenty eight (51.9%) were low or intermediate anomalies, 14 (50%) of which occurred in males and 14 (50%) in females. Twenty six (48.1%) children had high anomalies, 22 (84.6%) were males and 4 (15.4%) were females. Associated anomalies included umbilical hernia, Down's syndrome, cardiac anomalies, unilateral hydro-nephrosis.
Twenty one (75%) children with low anomalies had three staged surgical treatment; 14 (50%) of these patients are completely continent. Of the 26(48.1%) children with high anomalies, 12 (46.2%) had three staged procedures to complete treatment; 11 (91.7%) of these are fully continent.
Conclusion: Anorectal anomaly is not uncommon in Ghana. The results of treatment are generally satisfactory.


Keywords: Anorectal anomalies, constipation

African Journal of Paediatric Surgery Vol. 3 (1) 2006: pp. 4-8