Results of treatment in children with anorectal malformations in Calabar, Nigeria.

Leading symptoms of anorectal malformation in the neonatal period are abdominal distention, non-passage of meconium and constipation. When present, vomiting is a late symptom. In a study in Calabar, Nigeria, patients were observed to present late, and teenage mothers in rural communities were mostly affected. Female neonates were affected more than males in a ratio of 1.5:1. Classification into low and high abnormality was adopted and proved practical in terms of identification of the pathology and treatment of the lesion. Patients with low abnormality (N = 24, 44.4%) were treated with perineal cut-down, while those with high abnormality (55.6%) had initial palliative colostomy before a definitive abdominal perineal pull-through procedure. Faecal incontinence (13%), anal stenosis (11.1%), constipation (7.4%) and colostomy prolapse (5.6%) were noted to be associated complications. Poverty and ignorance were noted to be the main factors affecting treatment outcome. A concerted public enlightenment campaign is therefore required.