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[肛门直肠闭锁的延迟表现:一例病例报告]

[Late presentation of anorectal atresia: a case report].

作者信息

Dongmo Octave Excupère Désiré Miaffo, Mantho Pauline, Boume Missoki Azanlédji, Bitchoka Eric, Enyama Dominique, Kouna Irène, Kamguep Théophile, Engbang Jean Paul Ndamba

机构信息

Hôpital Gynéco-Obstétrique et Pédiatrique de Douala, Douala, Cameroun.

Faculté de Médecine et des Sciences Pharmaceutiques, Université de Douala, Douala, Cameroun.

出版信息

Pan Afr Med J. 2022 Jul 13;42:200. doi: 10.11604/pamj.2022.42.200.35576. eCollection 2022.

Abstract

Anorectal atresia and rectal stenosis are rare types of anorectal malformations, accounting for only 1-2% of cases. We here report one case of anorectal atresia. The study involved a female newborn baby delivered at term via vaginal birth, weighing 3600g, who was admitted with failure to pass meconium, abdominal bloating and fever on day 6 of life. Clinical examination showed a temperature of 39C, distended abdomen, normal anal location and peremeability, with prolapsed pinkish mass and no signs of necrosis. A cannula trocar stylet was inserted between the mass and rectal mucosa and stopped at about 3cm from the anal margin. Abdominal X-ray without treatment showed distended bowels and air-fluid levels, with no evidence of hollow-organ perforation. Due to suspicion of complete anorectal atresia, 16 gauge needle was inserted into the membrane and meconium was collected abundantly with considerable abdominal deflation. Surgical excision of the membrane was then performed. The postoperative course was uneventful and newborn baby was discharged at postoperative day 3. Anal dilatations were performed to treat anal stenosis. At 6-months´ follow-up, functional outcome was satisfactory. Anorectal atresia manifesting as failure to pass meconium associated with mass protruding through the anus has not yet been described in the literature. Membrane puncture confirmed the diagnosis. Membrane was resected with good outcome.

摘要

肛门直肠闭锁和直肠狭窄是罕见的肛门直肠畸形类型,仅占病例的1-2%。我们在此报告一例肛门直肠闭锁病例。该研究涉及一名足月顺产的女婴,体重3600g,出生后第6天因未排胎便、腹胀和发热入院。临床检查显示体温39℃,腹部膨隆,肛门位置及通透性正常,有粉红色肿物脱出,无坏死迹象。在肿物与直肠黏膜之间插入套管针芯,在距肛缘约3cm处受阻。未经治疗的腹部X线显示肠管扩张和气液平面,无中空器官穿孔迹象。由于怀疑为完全性肛门直肠闭锁,将16号针插入隔膜,引出大量胎便,腹胀明显减轻。随后进行隔膜手术切除。术后过程顺利,新生儿术后第3天出院。进行肛门扩张以治疗肛门狭窄。随访6个月时,功能结果满意。文献中尚未描述以未排胎便并伴有肛门肿物脱出为表现的肛门直肠闭锁。隔膜穿刺确诊了诊断。切除隔膜后效果良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f3f/9508370/481764a0e447/PAMJ-42-200-g001.jpg

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