肛门直肠畸形|概述
什么是肛门直肠畸形？
Anorectal malformations are birth defects in which the anus and rectum (the lower end of the digestive tract) don’t develop properly. They occur in an estimated 1 in 4,000 newborns and can range from mild to complex.
肛门直肠畸形包括几种不同的异常，包括：
- The anal passage may be narrow.
- 肛门开口上可能存在膜。
- The rectum may not connect to the anus (imperforate anus).
- 直肠可以通过称为瘘管的异常通道连接到尿路或生殖系统的一部分。
肛门直肠畸形的类型
厌食直肠畸形，包括不犯有肛门，可能会以不同的方式影响男性和女性婴儿。
In boys, the main anorectal malformations are perineal fistula, rectobulbarurethral fistula, rectoprostatic fistula and rectobladderneck fistula.
In girls, the main anorectal malformations are rectoperineal fistula, rectovestibular fistula and cloaca.
A type of anorectal malformation called imperforate anus can occur in both boys and girls.
我们如何照顾肛门直肠畸形
Anorectal malformations can be complex issues.The Colorectal and Pelvic Malformation Centerat Boston Children’s Hospital includes a comprehensive team of colorectal surgeons, urologists, gynecologists and gastroenterologists who evaluate the problem using advanced diagnostic tests and then provide a coordinated plan of care for children with anorectal malformations such as imperforate anus. Because the surgery is only the first step for many of these children, the center not only offers reconstructive surgical care, but lifelong management of bowel, bladder and reproductive issues as well.
We offer therapies that are limited to only a few centers around the world, such as:
- 肠道管理计划
- peristeen counseling
- sacral nerve stimulation
Our team also includes nutritionists, psychologists and other experts to improve the quality of life for each child entrusted to our care.
肛门直肠畸形|症状和原因
What are the symptoms of an anorectal malformation?
Anorectal malformations such as imperforate anus cause abnormalities in the way a baby has a bowel movement. These problems vary depending on the type of malformation:
- If the anal passage is narrow, your baby may have a difficult time passing a stool, causing constipation and possibly discomfort.
- If there is a membrane over the anal opening, your baby may be unable to have a bowel movement.
- If the rectum is not connected to the anus but there is a fistula present, stool will leave your baby's body through the fistula and enter the urinary tract instead of the anus. This can cause urinary infection.
- 如果直肠未连接到肛门，并且没有瘘管，则粪便无法离开肠道。然后，您的宝宝将无法排便，并且将堵塞肠道作为新生儿。
What causes anorectal malformations?
As a fetus is growing in its mother's uterus, all organ systems are developing and maturing at different rates. Certain steps have to take place in the seventh to tenth weeks of gestation for the rectum and anus to separate from the urinary tract and form properly. Sometimes these steps do not occur as they should, and the rectum, anus or both may not develop normally.
Most of the time, the cause for an anorectal malformation is unknown, but in rare cases, it appears to run in families. Boys are at a slightly higher risk for this abnormality than girls.
Up to one third of babies who have genetic syndromes, chromosomal abnormalities or other congenital defects also have imperforate anus or other anorectal malformations. These genetic syndromes and other congenital problems include:
- 摄影结合（综合征，其中有椎骨，肛门，心脏，气管，食管，肾脏和肢体异常）
- digestive system abnormalities
- 尿路异常
- 脊柱异常
肛门直肠畸形|诊断和治疗
如何诊断厌食直肠畸形？
婴儿的医生将在宝宝出生时进行体格检查，并会看着肛门，看看它是否开放并且处于适当的位置。如果医生怀疑肛门直肠畸形，他或她可能会下令进行诊断成像，以获取有关问题严重性的更多细节：
治疗的选择是什么ions for anorectal malformations?
The majority of babies with anorectal malformations will need to have surgery to correct the problem. The type and number of operations necessary depends on the type and extent of the abnormality.
Narrow anal passage
具有导致肛门通道狭窄的畸形类型的婴儿可能不需要操作。可以定期进行称为肛门扩张的程序，以帮助拉伸肛门肌肉，使粪便可以轻松地通过它。但是，如果肛门开口位置不正确，则可能需要操作来搬迁。
肛门膜
在手术期间，需要将这种类型的畸形的婴儿去除膜。之后可能需要进行肛门扩张，以防止肛门通道的狭窄。