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| Atresia Ani, Definition, Symptoms, Causes, Diagnosis, Treatment, Prevention, Complications |
Anal atresia or imperforate anus is a congenital abnormality that causes the anus to not form properly. As a result, the patient cannot pass stool normally. This condition usually occurs due to impaired fetal gastrointestinal development at 5-7 weeks of gestation.
Atresia ani is a fairly rare condition. This condition only occurs in 1 in 5,000 births and is more common in male babies. Atresia ani needs immediate treatment to prevent complications.
Causes of Atresia Ani
Atresia ani is one form of congenital abnormalities. The exact cause of atresia ani is not known. Atresia ani occurs randomly and can be experienced by anyone. However, there are allegations that link the condition to genetic disorders.
Atresia ani also often co-occurs with VACTREL conditions, a group of congenital disorders that can affect various body systems. VACTREL stands for vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula, renal anomalies, and limb defects.
When the fetus has abnormalities or disorders of the development of the digestive tract, pregnancy can also be disrupted. One condition that is often associated with atresia ani is the occurrence of polyhydramnios. Polyhydramnios is a condition where there is an excess of amniotic fluid levels that can be detected when pregnant women do a pregnancy test.
Risk factors for atresia ani
It is not known whether there are factors that can increase the risk of atresia ani. However, this condition is more common in male babies. Babies with atresia ani can also have other congenital abnormalities, including digestive tract disorders, urinary tract disorders, and VACTREL disorders.
Symptoms of Atresia Ani
Atresia ani is characterized by the shape of the rectum (the end of the large intestine) until the baby's anus is not fully developed.
Atresia ani consists of several forms, namely:
- The anal canal is narrowed or completely closed
- The rectum is not connected to the large intestine
- Formation of a fissure or channel that connects the rectum to the bladder, urethra, base of the penis, or vagina
Under normal conditions, the development of the anal canal, urinary tract, and genitals, in the fetus occurs in the first trimester of pregnancy or when the gestational age reaches 7-8 weeks. Atresia ani occurs when the development of these organs is impaired at this time.
Babies with atresia ani generally have the following symptoms:
- The anal canal is not in the right place, or is not born without an anal canal
- The anal canal is very close to the vagina in baby girls
- The first stool (meconium) does not come out within 24-48 hours after birth
- Stomach looks bigger
- Stool from the vagina, base of the penis, scrotum, or urethra
When to go to the doctor
Atresia ani can be detected during a physical examination of the newborn. However, pregnant women need to have regular prenatal checkups according to the schedule determined by the doctor. That way, the development of the fetus and the condition of pregnant women can be continuously monitored.
Usually if it is not detected at birth, the presence of an enlarged abdomen and not passing the first stool (meconium) can be a sign of atresia ani. If the baby has this complaint, immediately take the baby to the doctor so that a thorough examination can be done.
You are also advised to take the baby for regular checkups to the doctor. By doing regular checkups, the baby's growth and development can be monitored. In addition, if health problems are found, early treatment can be done, so as to prevent complications.
Diagnosis of Atresia Ani
When a new baby is born, the doctor or medical officer will perform a thorough newborn examination including confirming the presence or absence of an anal canal. If the anal canal is not found during the examination, the doctor will perform a series of follow-up examinations to confirm the condition of the baby.
Atresia ani is a congenital anomaly due to impaired fetal development. There are several other congenital abnormalities that can appear along with this condition, namely:
- Disorders of the urinary tract and kidneys
- Abnormalities in the spine
- Disorders of the respiratory tract
- Abnormalities in the esophagus
- Abnormalities in the arms and legs
- Down syndrome
- Congenital heart disease
- Hirschsprung's disease
- Duodenal atresia (abnormalities of the small intestine)
To detect congenital abnormalities that often occur along with atresia ani, the doctor will perform several other examinations, such as:
- Scans with X-rays, ultrasound, and MRI, to detect any bone abnormalities and examine the condition of the esophagus, throat, and related organs
- Echocardiography, to check the baby's heart condition
Atresia Ani Treatment
Treatment of atresia ani aims to improve the condition of the anus so that the baby can live a normal life. Prior to further treatment, babies who do not have an anal canal will be given nutrition and fluids through intravenous fluids. If a fistula forms in the urinary tract that increases the risk of infection, the doctor may prescribe antibiotics.
In general, treatment options that can be done to treat atresia ani are:
Operation
Surgery is the main treatment method for treating atresia ani. The goal of surgery is to make the digestive tract function normally. The type of surgery performed depends on the symptoms, age, type and complexity of the form of atresia ani that occurs, as well as the baby's health condition.
Some types of surgery that can be done to treat atresia ani are:
- Colostomy, which is making a hole (stoma) in the abdominal wall as a temporary drain. Stool that comes out of the stoma will be accommodated in a bag (colostomy bag).
- Pull through, which is surgery to connect the rectum and anus. Usually this surgery is done a few months after the first colostomy surgery.
- Closing colostomy, which is a follow-up operation to close the stoma, so that the patient can begin to excrete feces through the rectum and anus.
- Perineal anoplasty, which is surgery to close a fistula that is connected to the urinary tract or vagina. This procedure aims to make the anal canal in its proper position.
The success rate of surgery in correcting atresia ani can be said to be quite high.
Regulate diet
After undergoing surgery, people with atresia ani are advised to adjust their diet, such as consuming foods high in fiber and supplements and vitamins. This is so that the patient does not experience constipation.
Complications of Atresia Ani
Some of the complications that may occur due to atresia ani or after surgery are:
- Constipation
- Intestinal tear (perforation)
- Urinary tract infection
- Stool or urine incontinence
- Anal narrowing (anal stenosis)
Prevention of Atresia Ani
Atresia ani is a congenital or congenital disorder, so it is difficult to prevent. However, pregnant women can take the following steps to reduce the risk of abnormalities in the fetus:
- Do a genetic examination to the doctor if you have a history of atresia ani or other congenital abnormalities before planning a pregnancy
- Eat a healthy diet, don't smoke, and don't consume alcoholic beverages and drugs outside the doctor's advice during pregnancy
- Perform routine pregnancy check-ups and take supplements according to doctor's instructions
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