Repair of anorectal incontinence in an adolescent boy with neonatal anal atresia.

Fecal continence, the ability to retain intestinal contents until evacuation is desired, requires the complex interaction of several factors. They include: the motor action of the sphincters, sensibility of skin and sphincters and function of the rectum and central nervous pathways. Appropriate and effective management is available to treat many disorders of continence. However, the success of these treatments depends on careful delineation of the various contributing factors. The authors present the case of an 18-year-old boy with disabling fecal incontinence, secondary to neonatal anal atresia and its primary management, in order to illustrate the importance of careful assessment of each of the contributing factors. His staged surgical treatment has been successful in returning him to a more normal state.