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Bowel perforation in newborn with anorectal malformation and no fistula at presentation.
J Pediatr Surg. 2014 Mar; 49(3):390-4.JP

Abstract

PURPOSE

Anorectal malformation (ARM) in newborns with no fistula at presentation resembles intestinal obstruction. The aim of this study is to study the factors associated with bowel perforation in this group of patients.

METHODS

From 2000 to 2012, 106 newborns with ARM were managed in our hospital. Thirty neonates without fistula at presentation were included in this study. Demographic data and the incidence of bowel perforation were studied.

RESULTS

Twenty-nine male and 1 female were included in the study. Five patients were born premature and six patients had low birth weight. Six patients had Down's syndrome and 12 patients had associated anomalies. Cross-table lateral x-ray in prone position was performed from 20 to 24 hours after birth. All operations were performed within 48 hours after birth. One neonate underwent primary anoplasty. Twenty-nine neonates underwent colostomy. Two males developed bowel perforation before surgery (at 33 and 36 hours after birth). Perforation was associated with low birth weight (p=0.034) and was not associated with prematurity (p=0.31), Down's syndrome (p=0.634) or the presence of other associated anomalies (p=0.687).

CONCLUSIONS

In newborns with ARM, bowel perforation can occur within 36 hours after birth. Forty-eight hours of waiting is too long as it risks perforation. In this study, a neonate with low birth weight was trended toward bowel perforation.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Department of Surgery, Division of Paediatric Surgery and Paediatric Urology, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China. Electronic address: edwinchan@surgery.cuhk.edu.hk.

Department of Surgery, Division of Paediatric Surgery and Paediatric Urology, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.

Department of Surgery, Division of Paediatric Surgery and Paediatric Urology, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.

Department of Surgery, Division of Paediatric Surgery and Paediatric Urology, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.

Department of Surgery, Division of Paediatric Surgery and Paediatric Urology, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.

Department of Surgery, Division of Paediatric Surgery and Paediatric Urology, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.

Department of Surgery, Division of Paediatric Surgery and Paediatric Urology, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24650463

Citation

Chan, Kin Wai Edwin, et al. "Bowel Perforation in Newborn With Anorectal Malformation and No Fistula at Presentation." Journal of Pediatric Surgery, vol. 49, no. 3, 2014, pp. 390-4.

Chan KW, Lee KH, Tsui SY, et al. Bowel perforation in newborn with anorectal malformation and no fistula at presentation. J Pediatr Surg. 2014;49(3):390-4.

Chan, K. W., Lee, K. H., Tsui, S. Y., Wong, Y. S., Pang, K. Y., Mou, J. W., & Tam, Y. H. (2014). Bowel perforation in newborn with anorectal malformation and no fistula at presentation. Journal of Pediatric Surgery, 49(3), 390-4. https://doi.org/10.1016/j.jpedsurg.2013.07.009

Chan KW, et al. Bowel Perforation in Newborn With Anorectal Malformation and No Fistula at Presentation. J Pediatr Surg. 2014;49(3):390-4. PubMed PMID: 24650463.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Bowel perforation in newborn with anorectal malformation and no fistula at presentation. AU - Chan,Kin Wai Edwin, AU - Lee,Kim Hung, AU - Tsui,Siu Yan Bess, AU - Wong,Yuen Shan, AU - Pang,Kit Yi Kristine, AU - Mou,Jennifer Wai Cheung, AU - Tam,Yuk Him, PY - 2013/05/15/received PY - 2013/06/20/revised PY - 2013/07/21/accepted PY - 2014/3/22/entrez PY - 2014/3/22/pubmed PY - 2014/12/15/medline KW - Anorectal malformation KW - Fistula KW - Perforation SP - 390 EP - 4 JF - Journal of pediatric surgery JO - J Pediatr Surg VL - 49 IS - 3 N2 - PURPOSE: Anorectal malformation (ARM) in newborns with no fistula at presentation resembles intestinal obstruction. The aim of this study is to study the factors associated with bowel perforation in this group of patients. METHODS: From 2000 to 2012, 106 newborns with ARM were managed in our hospital. Thirty neonates without fistula at presentation were included in this study. Demographic data and the incidence of bowel perforation were studied. RESULTS: Twenty-nine male and 1 female were included in the study. Five patients were born premature and six patients had low birth weight. Six patients had Down's syndrome and 12 patients had associated anomalies. Cross-table lateral x-ray in prone position was performed from 20 to 24 hours after birth. All operations were performed within 48 hours after birth. One neonate underwent primary anoplasty. Twenty-nine neonates underwent colostomy. Two males developed bowel perforation before surgery (at 33 and 36 hours after birth). Perforation was associated with low birth weight (p=0.034) and was not associated with prematurity (p=0.31), Down's syndrome (p=0.634) or the presence of other associated anomalies (p=0.687). CONCLUSIONS: In newborns with ARM, bowel perforation can occur within 36 hours after birth. Forty-eight hours of waiting is too long as it risks perforation. In this study, a neonate with low birth weight was trended toward bowel perforation. SN - 1531-5037 UR - https://www.unboundmedicine.com/medline/citation/24650463/Bowel_perforation_in_newborn_with_anorectal_malformation_and_no_fistula_at_presentation_ DB - PRIME DP - Unbound Medicine ER -