With the purpose of defining the early complications of the surgical repair of high and low inperforate anus at Hospital Universitario San Vicente de Paul, Medellin, Colombia, we studied 128 cases operated on in the period January 1, 1995, and september 30, 2002. The most frequent type was the high imperforate anus and was most frequent in males, 2.76:1. Diagnosis was made by classical upside-down x-ray study in 54 cases. Fistulae of diverse location were detected in 98 boys and 101 patients exhibited malformations, 72 of which were related; fistulae more commonly appeared associated with the high type. Associated malformations were renal, osteomuscular, cardiac, and genital. Complications developed in 52 cases with imperforate anus of the high type; the most frequent were associated with colostomy, and also stenosis, recurrence of fistula and infections. Mortality rate was 3.1%, higher in high type but this rate is lower than the mortality reported in the literature. We conclude that the classical upside-down x-ray study is seldom utilized as a diagnostic method and that complications occur mostly in patients with imperforate anus of the high type, for these patients are likely to exhibit a higher number of associated problems and the corresponding surgical techniques are more complex.
Tópico:
Congenital gastrointestinal and neural anomalies
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