1. Imperforate Anus Information page including definitions, from Texas Pediatric Surgical Associates. http://www.pedisurg.com/PtEduc/Imperforate_Anus.htm

TEXAS PEDIATRIC SURGICAL ASSOCIATES IMPERFORATE ANUS What is imperforate anus? Imperforate anus is the absence of a normal anal opening. The diagnosis is usually made shortly after birth by a routine physical examination. Imperforate anus occurs in about 1 in 5000 births and its cause is unknown. Children who have imperforate anus may also have other congenital anomalies. The acronym VACTERL describes the associated problems that infants with imperforate anus may have: Vertebral defects, Anal atresia, Cardiac anomalies, Tracheoesophageal fistula, Esophageal atresia, Renal anomalies, and Limb anomalies. The incidence of kidney and bladder problems increases with the severity of the imperforate anus, ranging from 5 to 20 percent with low lesions up to 60 to 90 percent with high lesions. While some of these anomalies may be noted on physical examination, others require further diagnostic tests. Renal ultrasound is done shortly after birth on all infants to evaluate the kidneys. Chest X-ray, EKG, and cardiac ultrasound may be ordered to evaluate the heart. Other X-rays may be done to evaluate the trachea and esophagus and the spine. How is imperforate anus evaluated?

2. MedlinePlus Medical Encyclopedia: Imperforate Anus Repair adam.com provides quick, reliable answers to health questions. Definition of and about anorectal malformations and treatments. http://www.nlm.nih.gov/medlineplus/ency/article/002926.htm

@import url(/medlineplus/images/advanced.css); Skip navigation Medical Encyclopedia Other encyclopedia topics: A-Ag Ah-Ap Aq-Az B-Bk ... Z Imperforate anus repair Contents of this page: Illustrations Alternative names Definition Description ... Convalescence Illustrations Imperforate anus repair - series Alternative names Return to top Anorectal malformation repair; Perineal anoplasty Definition Return to top Imperforate anus repair is surgery to correct birth defects involving malformation of the rectum and anus. Normally, the large intestine (colon) empties into a pouch-like portion of bowel (rectum). Through complex nerve and muscle structures, the rectum releases stool through the anus out of the body. Infants with imperforate anus defect, however, have malformations of the rectum and anus in which abnormal development leads to growth of skin over the anus and incomplete development of the rectum. As a result, these infants have either no opening through which stool can pass, or a very small opening that allows only a small amount of stool to pass out of the rectum. This very small opening is often accompanied by fistulas, which are abnormal channels that connect skin to bowel. Variations of the defect include: Complete absence of an anal opening A small tube-like opening ( fistula ) from the bowel to the skin, vagina, or urethra

3. The Pull-thru Network's Home Page Nonprofit support and resource organization for families of children born with imperforate anus, cloaca, Hirschsprung's Disease and any of the associated defects. http://www.pullthrough.org/

Welcome to the Pull-thru Network! The Pull-thru Network was organized as a chapter of the United Ostomy Association in 1988 by a group of families whose children were born with an anorectal malformation. Today, the PTN is one of the largest organizations in the world dedicated to the support and information needs of the families of children born with imperforate anus, cloaca, cloaca exstrophy, bladder exstrophy, VATER Syndrome, Hirschsprung’s Disease and other related birth anomalies. Add us to your Favorites Showing our support for one of our own. Membership in the Pull-thru Network Membership in the Pull-thru Network is open to all persons interested in the development and welfare of children and adults who have had, or will have, a pullthrough type surgery or a permanent ostomy for the correction of anorectal malformations, colon disease or injury. PTN offers a variety of services to its members: The PTN News is the quarterly newsletter of the Pull-thru Network. Currently it is 24 pages in length and is sent through the US Mail. The articles range from medical information, “Good News” about our children, personal stories and helpful information related to the various issues faced by families of a child born with an ARM or colon disease. Members may also receive

4. Imperforate Anus imperforate anus is the absence of a normal anal opening. The diagnosis is usually made shortly after birth by a routine physical examination. http://tmsyn.wc.ask.com/r?t=an&s=hb&uid=24312681243126812&sid=343126

5. MedlinePlus Medical Encyclopedia Imperforate Anus Repair . Indications. Risks. Expectations......imperforate anus repair Contents of this page Illustrations. Alternative names. Definition. http://tmsyn.wc.ask.com/r?t=an&s=hb&uid=24312681243126812&sid=343126

6. MedlinePlus Medical Encyclopedia: Imperforate Anus Repair - Series: Normal Anato imperforate anus repair series Illustrations. Normal anatomy; Indications Procedure Aftercare. In individuals with a normal anatomy, http://www.nlm.nih.gov/medlineplus/ency/presentations/100030_1.htm

@import url(/medlineplus/images/advanced.css); Skip navigation Medical Encyclopedia Imperforate anus repair - series: Normal anatomy Imperforate anus repair - series Illustrations: Normal anatomy Indications Procedure Aftercare In individuals with a normal anatomy, the large intestine (colon) empties into a pouch-like portion of bowel (rectum). Through complex nerve and muscle structures, the rectum releases stool through the anus out of the body. Update Date: 10/25/2004 Updated by: Hebe Molmenti, M.D., Ph.D., Private Practice specializing in Plastic and Reconstructive Surgery, Baltimore, MD. Review provided by VeriMed Healthcare Network. Home Health Topics Drug Information Encyclopedia ... U.S. National Library of Medicine , 8600 Rockville Pike, Bethesda, MD 20894 National Institutes of Health Page last updated: 18 August 2005

7. The Pull-thru Network's Home Page Nonprofit support and resource organization for families of children born with imperforate anus, cloaca, Hirschsprung's Disease and any of the http://tmsyn.wc.ask.com/r?t=an&s=hb&uid=24312681243126812&sid=343126

8. EMedicine - Imperforate Anus : Article By Daniel A Beals, MD imperforate anus Congenital anomalies of the anus and rectum are relatively common. Minor abnormalities occur in approximately 1 per 500 live births; http://www.emedicine.com/ped/topic1171.htm

(advertisement) Home Specialties Resource Centers CME ... Patient Education Articles Images CME Advanced Search Consumer Health Link to this site Back to: eMedicine Specialties Pediatrics Gastroenterology Imperforate Anus Last Updated: June 14, 2004 Rate this Article Email to a Colleague Synonyms and related keywords: anal atresia, anal stenosis, covered anus, rectourethral fistula, anal agenesis, anterior ectopic anus, perineal fistula, rectoprostatic fistula, rectal fistula, cloacal malformation, Currarino syndrome, anorectal anomaly AUTHOR INFORMATION Section 1 of 9 Author Information Introduction Clinical Workup ... Bibliography Author: Daniel A Beals, MD , Associate Professor, Department of Surgery, Section of Pediatric Surgery, University of Kentucky Daniel A Beals, MD, is a member of the following medical societies: American Society for Bioethics and Humanities Editor(s): Hisham Nazer, MD , Professor, Department of Pediatrics, University of Jordan, Amman, Jordan; Mary L Windle, PharmD

9. SMA: Southern Medical Association - Page Moved Abstracts Primary repair of imperforate anus in an adult. http://www.sma.org/smj/96abcoln.htm

President's Welcome Mission/Vision Leadership Special Service Awards Press Releases FAQ Southern Medical Journal CME Calendar CME Online Library Request a Brochure Physicians Group Purchasing SMA Tours Insurance Resident and New Physicians Insurance Program Financial Services Retirement MBNA Credit Cards Paychex Table of Contents Featured CME Articles Invitation to Reviewers Reprint Information Osteoporosis Bone Buzz Practice Management New Physicians Travel Benefit Program Your Place In Today's Medicine Seminar Physician Mentoring Program Society of 1906 SMA Staff Services Vendors Resources Contacts Associations Coding Government Sites Health Information Resources Law Medical Schools Medical Societies State Societies About SMA Member Benefits Southern Medical Journal Medallion Level CME Practice Management Communities Residents Fundraising Online Resources Contact Us Page Moved The page that you are requesting has been moved or no longer exists. If you are looking for an article for the Southern Medical Journal, click here Southern Medical Association 35 Lakeshore Drive Birmingham, AL 35209

10. Imperforate Anus Background All anorectal malformations have routinely been classified by the term "imperforate anus " a condition recognized since antiquity. http://tmsyn.wc.ask.com/r?t=an&s=hb&uid=24312681243126812&sid=343126

11. EMedicine - Imperforate Anus: Surgical Perspective : Article By Marc A Levitt, M imperforate anus Surgical Perspective Anorectal malformations comprise a wide spectrum of disease affecting boys and girls and can involve malformations http://www.emedicine.com/ped/topic2923.htm

(advertisement) Home Specialties Resource Centers CME ... Patient Education Articles Images CME Advanced Search Consumer Health Link to this site Back to: eMedicine Specialties Pediatrics General Surgery Imperforate Anus: Surgical Perspective Last Updated: May 30, 2003 Rate this Article Email to a Colleague Synonyms and related keywords: AUTHOR INFORMATION Section 1 of 11 Author Information Introduction Indications Relevant Anatomy And Contraindications ... Bibliography Author: Marc A Levitt, MD , Assistant Professor of Surgery and Pediatrics, Albert Einstein College of Medicine; Consulting Surgeon, Division of Pediatric Surgery, Schneider Children's Hospital, North Shore - Long Island Jewish Health System Coauthor(s): Alberto Pena, MD , Professor of Surgery, Albert Einstein College of Medicine; Chief, Department of Pediatric Surgery, Schneider Children's Hospital, North Shore - Long Island Jewish Health System Marc A Levitt, MD, is a member of the following medical societies: Alpha Omega Alpha American College of Surgeons International Pediatric Endosurgery Group , and Society of American Gastrointestinal Endoscopic Surgeons Editor(s): Robert Kelly, MD

12. Personal Experiences & Notes On on the care of a child with imperforate anus http://members.tripod.com/jim_pendergraft/project.htm

setAdGroup('67.18.104.18'); var cm_role = "live" var cm_host = "tripod.lycos.com" var cm_taxid = "/memberembedded" Search: Lycos Tripod Star Wars Share This Page Report Abuse Edit your Site ... Next the Care of a Child with Imperforate Anus NOTICE The relevance of any information contained in this document to a particular person should be discussed by the family with their own physicians. I am not a doctor and can not guarantee the accuracy of the information provided here. Updated: October 10, 2001 kpendergraft@nc.rr.com Introduction - How to Make the Best Use of This General Information Health Resume Medical Records ... Appendix A - Detailed Outline Introduction - How to Make the Best Use of This This document came into being from a combination of factors. First, the pullthrough list archives prior to Jan. 2000 are no longer accessible. I had saved many notes on various topics relating to Stephen’s problems that I thought could help other parents. Second, there are parents who have no computer access who could benefit from the information on the PTL list serv and on the web. Finally, and most importantly, my husband and I felt strongly that God was calling me to organize the information I had to help other parents.

13. Personal Experiences Notes On on the care of a child with imperforate anus http://tmsyn.wc.ask.com/r?t=an&s=hb&uid=24312681243126812&sid=343126

14. Imperforate Anus: Background Anorectal Malformations imperforate anus. General Background An imperforate anus is caused by this process not being completed. http://www.pullthrough.org/Background.html

Anorectal Malformations: Imperforate Anus General Background All anorectal malformations have routinely been classified by the term "imperforate anus," a condition recognized since antiquity. Studies show that anorectal malformations occur in varying degrees in one out of every 4,000 newborns. This translates to approximately 600 children born each year in the U.S. Females seem to suffer this condition less frequently than males. There is no known cause for the condition which runs equally through all racial, social, cultural and economic groups. One thing is known: Parents should never blame themselves for the condition. There is no evidence to suggest it is caused by something done as an adolescent, on the night of conception or during the pregnancy. The complex miracle of reproduction sometimes just goes astray. These defects probably develop during the 4th to 12th week of gestation. As the fetus grows, all of the internal organs begin in a mass, and slowly spread out, until they separate. During normal development, the urethra and lower colon begin distending as one, and separate before completing their respective descents. An imperforate anus is caused by this process not being completed. The uncompleted developmental steps must be done surgically. There are many types of anorectal malformations. Each one has specific characteristics and carries a specific prognosis. When the colon is located high in the pelvis, most surgeons describe it as

15. Imperforate Anus Repair imperforate anus repair. Injury Disease Nutrition Poison Symptoms Surgery Test Special Topic. A B C D E F G H I K L M O P R S T U V http://tmsyn.wc.ask.com/r?t=an&s=hb&uid=24312681243126812&sid=343126

16. PTN Glossary-Diagnosis High imperforate anus is a congenital defect wherein the opening in the Standard Female Anatomy Low imperforate anus (Female) High imperforate anus http://www.pullthrough.org/glossary/diagnosis.htm

The Pull-thru Network Glossary Diagnosis This web page is NOT a list of "problems to expect", rather, it is a compilation of medical problems (associated with "pull through" surgeries or not) experienced by members of the Pull-Thru Network (and/or their parents or caregivers). Jump to: Anorectal-Malformations Caudal-Regression Cloaca Cloacal-Exstrophy ... VATER (VACTERL, others) Syndrome Caudal Regression Caudal Regression Syndrome is a rare disorder characterized by abnormal development of the lower spine end of the developing fetus. A wide range of abnormalities may occur including partial absence of the tailbone end of the spine causing no apparent symptoms, to extensive abnormalities of the lower vertebrae, pelvis, and spine. Neurological impairment as well as inability to control urination and bowel movements (incontinence) may occur in severe cases. Click to jump to the National Organization for Rare Disorders, Inc.(NORD) or the NIH/National Institute of Child Health and Human Development Back to the TOP Cloaca Any of a spectrum of congenital defects that, in females, includes the

17. UCSF Fetal Treatment Center Fetal diagnosis and treatment of birth defects at UCSF with a information for birth defects diagnosis and fetal therapy. http://tmsyn.wc.ask.com/r?t=an&s=hb&uid=24312681243126812&sid=343126

18. Pediatric Surgery | Minimally Invasive Surgery | Imperforate Anus imperforate anus is a birth defect that occurs in about one of every 5000 newborns. It is somewhat more common in boys than girls and may include a single http://www.ucsfhealth.org/childrens/medical_services/surgical/minimal/conditions

University of California, San Francisco About UCSF Search Welcome Hospitals and Clinics Appointments Billing ... Events and Classes Minimally Invasive Surgery Imperforate Anus Signs and Symptoms Diagnosis Treatment Signs and Symptoms Imperforate anus is a birth defect that occurs in about one of every 5,000 newborns. It is somewhat more common in boys than girls and may include a single abnormality or a combination of abnormalities of the rectum, (the end of the intestine near the anus), and anus, (the opening of the rectum). There is no known cause for this condition. There are many forms of this birth defect including: The absence of an anal opening. An anal opening in the wrong position, usually a very small opening. A connection, or opening called a fistula, between the rectum and the urethra, bladder or vagina. In girls, the rectum, urethra and vagina can join together to form a single opening. This is called a cloaca and is very rare. If the opening of the anus is missing, your baby will not be able to pass stool after birth. Because the intestine ends in a blind pouch, instead of opening to the skin, baby stool (called meconium) is retained in the intestine. This can cause vomiting and an enlarged or swollen abdomen. The rectum can end high in the pelvis, far away from the skin surface, or it can end low or very close to the skin. If there is a fistula or connection between the intestine and the urethra or bladder, stool may be passed with the baby's urine. If there is a fistula between the intestine and the vagina, meconium may pass out of the vagina.

19. Cecostomy.com - Home Page A new technique and catheter changing the lives of patients with fecal incontinence http://tmsyn.wc.ask.com/r?t=an&s=hb&uid=24312681243126812&sid=343126

20. Pediatric Surgery | Minimally Invasive Surgery | Imperforate Anus imperforate anus. Signs and Symptoms Diagnosis Treatment. Treatment. If the anus is missing, an operation will be needed to make an opening, or new anus http://www.ucsfhealth.org/childrens/medical_services/surgical/minimal/conditions

University of California, San Francisco About UCSF Search Welcome Hospitals and Clinics Appointments Billing ... Events and Classes Minimally Invasive Surgery Imperforate Anus Signs and Symptoms Diagnosis Treatment Treatment If the anus is missing, an operation will be needed to make an opening, or new anus, for stool to pass. When the intestine ends high in the pelvis (the area below the abdomen, between the hips), this is usually done in two operations. First a stoma, or opening of the intestine to the abdomen, is made and the rectum is pulled down to the anus where a new anal opening is made. During the operation, if a fistula is present, it will be closed to prevent stool from entering the urinary tract or vagina. The stoma is closed in a second operation, several months later, after the new anal opening has healed. In some newborns, the rectum can be pulled down to the anus and a new opening created in a single operation, using small instruments. This is called laparoscopy. In this case, a stoma is not needed and the entire defect is repaired in a single operation. If the intestine is low in the pelvis, close to the skin surface, an anal opening can be made and the intestine can be sewn to the skin. If the anal opening is in the wrong position, it will be closed and moved to the correct place. This operation is called an anoplasty and is performed soon after birth. It is usually done in a single operation.

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