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. 2018 Apr-Jun;15(2):118-120.
doi: 10.4103/ajps.AJPS_10_18.

Malformations: A 5-year review of the presentation and management in a Teaching Hospital in Ghana

Abiboye C Yifieyeh  1 , Babatunde M Duduyemi  2 , Anthony Enimil  3 , Michael Amoah  1 , Boateng Nimako  1
Affiliations

Malformations: A 5-year review of the presentation and management in a Teaching Hospital in Ghana

Abiboye C Yifieyeh et al. Afr J Paediatr Surg. 2018 Apr-Jun.

Abstract

Background: Anorectal malformations (ARMs) are congenital defects affecting the distal gastrointestinal tract and anus with frequent fistulous connections to the genitourinary system. The spectrum of the disease is considerably wide, and thus, an individualised approach to its management is required. There are few recent publications about the burden of this malformation in Africa and the outcome of surgical intervention. We present our experiences with the management of ARM, peculiar challenges and the outcome at a tertiary hospital catering for the Northern and Central parts of Ghana.

Materials and methods: This was a retrospective folder review of children with ARM at the Paediatric Surgical Unit of Komfo Anokye Teaching Hospital, Kumasi, Ghana, from 2011 to 2015. The data extracted included diagnosis, associated features, initial and definitive surgical treatment and post-operative complications.

Results: Of the 53 records that were conclusively retrieved, the sex ratio was 1:1. The median age of presentation was 4.5 days (neonates), 4.5 months (infants) and 1.6 years (older children). There were 12 (44%) rectoperineal and 18 (69%) rectovestibular fistulas, representing the most common types of ARM in boys and girls, respectively. Posterior sagittal anorectoplasty and abdominoperineal pull-through were the corrective procedures performed. The overall complication rate was <10%.

Conclusion: Our patients generally presented later than their Western counterparts, making a single-stage correction rare. The types of ARM documented in our study suggest the existence of a geographical variation.

Keywords: Abdominoperineal pull-through; anorectal malformation; congenital; posterior sagittal anorectoplasty.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Distribution of our patients according to age group and gender
Figure 2
Figure 2
Gender distribution of the types of anorectal malformations
Figure 3
Figure 3
Gender distribution of our patients with high lesions
Figure 4
Figure 4
Gender distribution of our patients with low lesions
Figure 5
Figure 5
Frequency and types of complications encountered in our patients
See this image and copyright information in PMC

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