0 The puborectal muscle, chosen as the anatomical determinant, is very important in normal stool control and is classified as high, low or intermediate anorectal anomalies according to this level.
0 ARMs occur with a frequency of 1/4000-5000. 2/3 are boys and 1/3 are girls.
0 The high type is seen in boys, while the low type is usually seen in girls.
0 There is a fistula between the rectum and the genital or urinary system in 75% of the cases.
0 In Males:
• The most common rectourethral fistulas are seen. The second most common are perineal fistulas.
• 50% of the cases with anorectal agenesis without fistula are seen in patients with Down syndrome.
0 In girls:
• Rectovestibular fistulas are most common. The second most common ancutaneous fistula is seen.
• In all infralevator lesions in girls, there is definitely a fistula opening in the perineum where meconium can come out.
0 Most common; high type anorectal agenesis is low type anocutaneous fistula.