Clinical Differentiation between a Normal Anus, Anterior Anus, Congenital Anal Stenosis, and Perineal Fistula: Definitions and Consequences—The ARM-Net Consortium Consensus

Autor: Eva E. Amerstorfer, Eberhard Schmiedeke, Inbal Samuk, Cornelius E. J. Sloots, Iris A. L. M. van Rooij, Ekkehart Jenetzky, Paola Midrio, ARM-Net Consortium
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Children, Vol 9, Iss 6, p 831 (2022)
Druh dokumentu: article
ISSN: 2227-9067
DOI: 10.3390/children9060831
Popis: In the past, an anteriorly located anus was often misdiagnosed and treated as an anorectal malformation (ARM) with a perineal fistula (PF). The paper aims to define the criteria for a normal anus, an anterior anus (AA) as an anatomic variant, and milder types of ARM such as congenital anal stenosis (CAS) and PF. An extensive literature search was performed by a working group of the ARM-Net Consortium concerning the subject “Normal Anus, AA, and mild ARM”. A consensus on definitions, clinical characteristics, diagnostic management, and treatment modalities was established, and a diagnostic algorithm was proposed. The algorithm enables pediatricians, midwives, gynecologists, and surgeons to make a timely correct diagnosis of any abnormally looking anus and initiate further management if needed. Thus, the routine physical inspection of a newborn should include the inspection of the anus and define its position, relation to the external sphincter, and caliber. A correct diagnosis and use of the presented terminology will avoid misclassifications and allow the initiation of correct management. This will provide a reliable comparison of different therapeutic management and outcomes of these patient cohorts in the future.
Databáze: Directory of Open Access Journals