Le pronostic fonctionnel et le traitement des séquelles des malformations anorectales chez l’adolescent et l’adulte
(2001) Acta Endoscopica — Vol. 31, n° 5, p. 649-658 (2001)
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- (en) Anorectal malformations occur with a frequency of 1/5,000 newborns and constitute a pathological spectrum, categorized in low and high defects according to their anatomical characteristics and their specific potential for the affected patients to reach fecal continence. The neonatal management should include a complete work-up for associated anomalies (VACTERL entity). The surgical strategy consists in a one/two/three-step approach, according to the anatomical type of anorectal defect and the need for a protective colostomy. The long-term functional sequelae and their management will depend on the type of anorectal malformation: 1) low defects have a good prognosis in term of fecal continence, but may be associated with severe constipation and megarectum responsible of fecal soiling (overflow pseudoincontinence); 2) the functional prognosis of high defects is worse, with possibility of developing fecal incontinence which should be identified in early childhood (3–5 years) in order to offer adequate management (conservative measures and/or bowel management) allowing school attendance with fecal cleanliness. The autonomy of the adolescent can be improved subsequently by means of self-administered antegrade colonic enemas through an umbilical continent appendicostomy.
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Reding, R., Crispin, B., Castille, Y., Jodogne, N., Saint Martin, C., Clapuyt, P., Serrano, J., Evrard, V., Wese, F.-X., Otte, J.-B., & Buts, J.-P. (2001). Le pronostic fonctionnel et le traitement des séquelles des malformations anorectales chez l’adolescent et l’adulte. Acta Endoscopica, 31(5), 649-658. https://doi.org/10.1007/BF03022139 (Original work published 2001)