0 The most complex ARM in girls is when the rectum, vagina, and the last parts of the urinary system are combined into a single cavity.
0 Diagnosis is made clinically. If the external genital organs are small in girls with anal atresia, it should be considered.
0 Hydrocolpos is present in 50% of cases.
0 There is bilateral megaureter.
0 Associated with vaginal and uterine duplications or septations.
0 50% ARM is accompanied by additional anomaly. The frequency of additional anomaly in high and intermediate type is 2 times higher.
0 The most striking additional anomalies are vertebral (sacral) and urinary system anomalies.
0 Tethered cord is the most common example of spinal dysraphism with ARM.
0 The most common additional anomaly is the GENITOURIRINE SYSTEM anomalies. The most common GUS anomaly is vesicoureteral reflux (VUR). Renal agenesis and dysplasia are the second most common.
0 CVS anomalies; VSD, tetralogy of Fallot
0 GIS anomalies; Esophageal atresia is the most common.
0 is part of the VATER and VACTERL syndromes.
0 They are the most common malformations accompanying genitourinary system anomalies.
0 Perineal examination is very important.
0 In every newborn, even if the anus appears normal, it should be checked with a soft probe or with a finger.
0 Infants have bloating and fecaloid vomiting.
0 Chest X-ray, ECG, ECO, vertebral X-rays, SDAR are used in the diagnosis.
0 Pearl sign; In the scrotal raphe is white meconium.
0 Luggage handle sign; It is a skin fold where the anus should be.
0 When the baby cries, there is bulging where the anus should be.
0 Boys do not have folds between the glutes; flat hip sign
0 In order to detect the presence of a recto-urinary fistula, urine analysis must be performed.
0 After 24 hours after birth, the level of the anomaly is determined by invertogram.
0 The treatment is surgical and various procedures are applied according to the location and type of the anomaly.