At first glance, imperforated anus seems like a strange medical concoction of a name, but when you really pay attention, it starts to make sense. Imperforated, meaning “not perforated or opened” and anus, which we all know. This condition is when a baby is born without an opening where his or her anus should be.
Any birth defect can have a devastating effect on the parents of a child and as far as physical deformities go, an imperforated anus seems pretty tame. After all, it isn’t something you notice until you examine the baby closely, but it will affect his entire life, especially for the first few years.
Babies who are born with an imperforated anus are almost always given an immediate colostomy. This is where the intestines are actually brought to the outside of the body, so the child can defecate through the colostomy, on the side of his body. The two ends of the intestine are called stoma and they are basically turned inside out and sewn to the outside of the abdomen, allowing for easy defecation, usually into a colostomy bag which is stuck with special adhesive to the stomach.
In nearly every case, an imperforated anus can be corrected with proper surgery. Most surgeons won’t even consider operating (except in emergencies, such as the colostomy) on a baby under 3 months and who weighs less than 10 lbs. The baby will have his colostomy for at least 3-6 months, if not much longer.
Depending on the severity of the disorder, the baby may have just three surgeries in total, while others will need more to fix the problem. The simplest condition is where the intestines are either very low, almost reaching the anus, or actually connected, with just a piece of skin covering where the opening should be. The latter often produces meconium or mucus which may escape through a small fistula in the anus. These babies will usually only need anal reconstruction and then, once that is healed, the colostomy will be closed and they should be able to continue on, pooping normally.
However, there are more severe forms of the imperforated anus, where the intestine doesn’t even extend below the pelvis. In this case, surgery will be needed to bring the intestines down into position, as well as the other regular operations. In other cases, the child’s intestines may actually be connected to other areas, such as the vagina or urethra, causing them to defecate through these channels. These babies will need more extensive surgery to repair the damage.
There is nothing in particular that causes an imperforated anus, although it tends to be genetic (i.e. someone in one of the parents´ families probably had this condition). It occurs early on in the pregnancy, when the intestines are forming and do not open to the outside of the body as they should. It is not preventable and rarely shows up on ultrasounds.
Once the surgeries are complete, the child will be left with a long scar on his side, perhaps two, depending on how complicated the condition was. Many children require a special diet to keep them regular and it may take longer than normal for them to potty train. However, most children born with an imperforated anus go on to live happy, healthy lives and don’t even remember why they have their scar.
