Ogundoyin O O, Afuwape O O, Olulana D I, Lawal T A
Afr J Med Med Sci. 2013 Dec;42(4):359-60.
Anorectal malformations (ARM) are usually diagnosed at birth, although, some patients have presented in the hospital beyond the newborn period without recognition of the anomaly. Late presentation in adulthood has also been reported. We report a case of adult ARM whose mother was instructed not to present in the hospital until she was old enough.
An adult female patient was evaluated and investigated preoperatively for high ARM with rectovestibular fistula. She had an initial colostomy which was followed by a primary posterior sagittal anorectoplasty (PSARP). Post-operatively, continent level was assessed using the Kelly continent score.
She had good post-operative recovery with an episode of faecal soilage. The Kelly continent score was 3 which later improved to 5.
Although the sphincteric tone may be weak in the adult patient with ARM with reduced continent level at the initial stage, overall outcome of management of ARM with primary PSARP is good and comparable to outcome in children.
肛门直肠畸形（ARM）通常在出生时被诊断出来，不过，一些患者在新生儿期过后才到医院就诊，且未被识别出存在该异常情况。也有成年期才出现该疾病的报道。我们报告一例成年ARM患者，其母亲曾被告知在她年龄足够大之前不要去医院就诊。
对一名成年女性患者进行术前评估和检查，以确定其患有伴有直肠前庭瘘的高位ARM。她最初接受了结肠造口术，随后进行了一期后矢状位肛门直肠成形术（PSARP）。术后，使用凯利控便评分评估控便水平。
她术后恢复良好，但有一次粪便污染情况。凯利控便评分为3分，后来提高到了5分。
虽然患有ARM的成年患者初始阶段括约肌张力可能较弱且控便水平降低，但采用一期PSARP治疗ARM的总体效果良好，与儿童患者的治疗效果相当。
