Ein S H
Division of General Surgery, Hospital for Sick Children, Toronto, Ontario, Canada, M5G 1X8.
Pediatr Surg Int. 1997 Jul;12(5-6):449-51. doi: 10.1007/BF01076966.
A male baby was born to a healthy mother after an uncomplicated 39-week pregnancy. He had finger and toe syndactyly, right hemidiaphragm eventration, and a high imperforate anus (anal agenesis). The kidneys and chromosomes were normal. A right transverse colostomy was done and 5 months later he underwent a posterior sagittal anorectoplasty (Pena procedure). An intermediate imperforate anus with no urethral fistula and a rectal atresia 2 cm proximal to the distal rectal pouch were found; the distal rectal pouch was resected and the standard Pena procedure completed. Dilatations were initiated 2 weeks postoperatively and continued until the colostomy was closed. Prior to closure of the colostomy, a distal colon loopogram demonstrated an obstruction in the sigmoid; constrast introduced via the rectum outlined the same obstruction separated by 2 cm. A low sigmoid atresia was then repaired. Three weeks later, a contrast loopogram showed a narrow but intact rectosigmoid anastomois, and the colostomy was closed. The anorectal dilatations were discontinued and he remains well at 7 years of age.
一名男婴在怀孕39周且无并发症的情况下，由一位健康的母亲产下。他患有手指和脚趾并指畸形、右侧半膈膨出以及高位肛门闭锁（肛门发育不全）。肾脏和染色体正常。进行了右侧横结肠造口术，5个月后他接受了后矢状位肛门直肠成形术（佩纳手术）。发现为中度肛门闭锁，无尿道瘘，直肠闭锁位于远端直肠袋近端2厘米处；切除远端直肠袋并完成标准的佩纳手术。术后2周开始进行扩张，并持续至结肠造口关闭。在结肠造口关闭前，远端结肠灌肠造影显示乙状结肠梗阻；经直肠注入造影剂勾勒出同一梗阻，相距2厘米。随后修复低位乙状结肠闭锁。三周后，灌肠造影显示直肠乙状结肠吻合口狭窄但完整，结肠造口关闭。停止肛门直肠扩张，他7岁时情况良好。
