Imperforate Anus Associated with Oesophageal Atresia and Tracheo- Esophageal Fistula: Sequential Coexistence of Disease

Abstract

Anorectal anomalies (imperforate anus) include a group of related anomalies of the hindgut. There are frequently other visceral and skeletal anomalies in patients with anorectal anomalies. These include abnormalities of the spine (sacral anomalies), urinary tract (urogenic bladder), and gastrointestinal tract (atresia and tracheoesophageal fistula) . The etiology of imperforate anus is unknown; but the most acceptable theory implicates faulty development of the primitive mesoderm at about the 7th week of life . The condition has an incidence of 1:5000 worldwide; males are more affected than females with a ratio of 3.2 .

Additional congenital anomalies in association with imperforate anus are well known, the most common being other associated atresias of the gastrointestinal tract and oesophageal atresia . The acronym VATER has been used to describe several congenital anomalies which have a greater than random tendency to occur together. The letters represent the anomalies involved. V = Vetebral defects: A = Anorectual anomalies: TE = esophageal atresia with Tracho oesophageal fistula: R = radial and renal anomalies . An understanding of the interrelationship of these anomalies is important to the radiologist, as he often has an overview of these patients and is able to alert his colleagues to the associated anomalies. This case depicts the importance of the VATER concept.

West African Journal of Radiology Vol.7(1) 2000: 9-12