Munyali Alumeti, Buhendwa Cikwanine, Ganywamulume Balagizi, Gloire Byabene, Ndanda Luhiriri, Longombe Ahuka Ona
Surgery Department, Faculty of medicine and public health, Evangelical University in Africa, Bukavu, South Kivu, the Democratic Republic of the Congo; Surgery Department, Faculty of medicine, Official University of Bukavu, Bukavu, South Kivu, the Democratic Republic of the Congo; Surgery Department, Panzi General Referral Hospital, Bukavu, South Kivu, the Democratic Republic of the Congo; Pillar of legal medicine, Sexual Violence Survivors Program, Panzi general referal hospital, Bukavu, South Kivu, the Democratic Republic of the Congo; Research department, Natural Sciences Research Center, Lwiro, Kabare, South Kivu, the Democratic Republic of the Congo.
Surgery Department, Faculty of medicine and public health, Evangelical University in Africa, Bukavu, South Kivu, the Democratic Republic of the Congo; Anaesthesia and Intensive Care Department, Panzi General Hospital, Bukavu, South Kivu, the Democratic Republic of the Congo.
Int J Surg Case Rep. 2025 Feb;127:110913. doi: 10.1016/j.ijscr.2025.110913. Epub 2025 Jan 20.
Anorectal malformations (ARM) are an anatomically complex in which anorectum is either agenesic or communicates with neighboring organs. They are rarely found in adolescents. The aim of this study was to describe and discuss according to literature the three cases of ARM in adolescents.
There were three young girls who were 12, 17 and 18 years old, transferred to the department of surgery for investigation and management. One of them consulted for chronic constipation and the two others for recto-vestibular fistula. One patient was admitted with a left colostomy. For the two others, no previous surgery had been performed. The diagnosis was made after a review of the perineum. The treatment consisted of a lowering according to Peña. The postoperative course was uneventful. For the three cases, evaluation of their fecal continence by Hassink criteria was good after surgery. At up to 18 months later; those patients had presented no symptoms.
Each patient consulted with a specific complaint, including elimination of feces through the vagina and chronic constipation; clinical signs of associated malformations were absent in our patients. Clinical examination of the perineum allowed diagnosis and typing of ARM in these three patients.
Anorectal malformations should be diagnosed during the first examination of a newborn. The presence of a large fistula represents a trap that often laid to late diagnosis in children and teenager suffering from chronic constipation evolving since birth.
肛门直肠畸形（ARM）是一种解剖结构复杂的疾病，其中肛门直肠要么发育不全，要么与邻近器官相通。青少年中很少见。本研究的目的是根据文献描述和讨论青少年ARM的三例病例。
有三名分别为12岁、17岁和18岁的年轻女孩，转入外科进行检查和治疗。其中一名因慢性便秘就诊，另外两名因直肠前庭瘘就诊。一名患者因左结肠造口术入院。另外两名患者此前未接受过手术。经会阴检查后作出诊断。治疗采用佩尼亚（Peña）提出的下移术。术后过程顺利。对于这三例病例，术后根据哈辛克（Hassink）标准评估其大便失禁情况良好。在长达18个月后，这些患者均未出现症状。
每位患者都有特定的主诉，包括经阴道排便和慢性便秘；我们的患者中没有相关畸形的临床体征。对会阴进行临床检查有助于对这三名患者的ARM进行诊断和分型。
肛门直肠畸形应在新生儿首次检查时诊断出来。大瘘管的存在是一个陷阱，常常导致自出生以来就患有慢性便秘的儿童和青少年延迟诊断。
