Congenital Abnormalities of the Anus and Rectum

Abstract

The division of these anomalies into high and low types is of assistance both in treatment and prognosis, and is justified by the figures we have given and which bear repeating. Results of treatment show 86% good results in the low cases compared with 30% in the high; 25% of the low cases have associated anomalies, compared with 62% of the high, and the latter are usually of a more severe nature. The mortality rate for the low cases is 5.7% and for the high cases 35.9% and this figure is corrected for anorectal agenesis seen and treated in the neonatal period rises to 46%. This is the largest series of these cases yet recorded. Well-documented series have been reported from the United States, but unfortunately comparison with our results is impossible owing to differences of classification, e.g. the covered anus in our classification is a low anomaly, in Ladd''s classification it would be Type 3 and be grouped with the high anomaly we call anorectal agenesis. There is certainly a place for standardization of nomenclature and we hope that this system will recommend itself.