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Worldwide, more than a million children are born each year with anorectal malformation or imperforate anus. The Colorectal Center for Children at UPMC Children's Hospital of Pittsburgh offers a comprehensive approach to treatment for children born with this anomaly.
When a baby is born without an anus, the rectum may end in various abnormal forms, a generic name for these alterations is ARM or imperforate anus. Both names refer to the same condition.
No. Anorectal malformation is a group of anorectal anomalies with different anatomical characteristics. For a better understanding, please view the anatomical illustrations of the pelvic anatomy of a boy and a girl provided below. These represent the most common anorectal malformations that are present in children.
An ARM is typically diagnosed during the newborn’s initial physical exam. A thorough physical exam allows a timely identification of the most frequent forms of ARM.
Yes, the most frequent associated defects are found in the sacrum (lower segment of the spine) and kidneys. When an ARM is dected in a baby, an ultrasound of the spine and kidneys and x-rays of the spine are mandatory. These studies help to establish initial treatment and prognosis.
All children with an ARM need at least one operation called an anorectoplasty or “pull-through”. Many children in the first days of life require a colostomy prior to pull-through surgery. The colostomy is a surgical procedure that brings a segment of the large intestine out through an opening called a stoma that is made in the abdominal wall; this is a temporary situation and the colostomy is closed a few weeks after pull-through surgery.
The pull-through wound should be kept clean and dry. Two weeks after pull-through surgery, your child will start anorectal dilatations to open the anus to a normal size and to prevent stenosis or closure. Your pediatric surgeon and nurse will teach you this easy procedure.
Intestinal function and fecal continence vary according to the type of ARM and if your child has an associated defect mainly in the sacrum. Your child will need long-term follow up to detect and treat any of the following problems in a timely manner:
The Bowel Management Program at the Colorectal Center for Children is a comprehensive program to help your child to control his/her bowel movements. Our goal is to improve quality of life, social integration, and self-esteem.
Anorectal Malformation (ARM) (PDF)
For more information about anorectal malformations or to request an appointment with the Colorectal Center for Children at Children’s Hospital of Pittsburgh of UPMC contact us at 412-692-7280 or by email at colorectalcenter@chp.edu.
Children's Hospital's main campus is located in the Lawrenceville neighborhood. Our main hospital address is:
UPMC Children’s Hospital of Pittsburgh One Children’s Hospital Way 4401 Penn Ave. Pittsburgh, PA 15224
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