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

Children

ARM-Net Consortium¹  Eberhard Schmiedeke²  Iris A. L. M. van Rooij³  Eva E. Amerstorfer⁴  Inbal Samuk⁵  Ekkehart Jenetzky⁶  Cornelius E. J. Sloots⁷  Paola Midrio⁸ 

[1] ;Clinic for Paediatric Surgery and Paediatric Urology, Klinikum Bremen Mitte, 28205 Bremen, Germany;Department for Health Evidence, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands;Department for Pediatric and Adolescent Surgery, Medical University of Graz, 8036 Graz, Austria;Department of Pediatric and Adolescent Surgery, Schneider Children’s Medical Center of Israel, 4920235 Petach Tikva, Israel;Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany;Pediatric Surgery Department, Erasmus MC-Sophia Children’s Hospital, 3015 CN Rotterdam, The Netherlands;Pediatric Surgery Unit, Cà Foncello Hospital, 31100 Treviso, Italy;

关键词: anorectal malformation;    anterior anus;    anal position index;    perineal fistula;    anal stenosis;    ARM-Net Consortium;   

DOI  :  10.3390/children9060831

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown