Children with anorectal and pelvic malformations such as imperforate anus and anal atresia require long-term bowel management. [ Ссылка ]

In This Video:
0:38 About Anorectal Malformations: Anal Atresia/Imperforate Anus
1:43 Treatment with Colostomy
2:37 Pull-Through Procedure for Anal Atresia/Imperforate Anus
4:09 Long-Term Coordinated Care for Anorectal Malformations

The Pediatric Anorectal Continence Evaluation (PACE) Program at The Children's Hospital of Philadelphia brings together top pediatric specialists in general surgery and gastroenterology to provide comprehensive care in one location for children with anorectal and pelvic malformations, including anal atresia, and other long-term bowel management needs.

Anorectal malformation (also known as imperforate anus) is a congenital anomaly where the anus and rectum don’t develop properly while a fetus is developing during pregnancy. This can range from the anal opening being in the wrong location to the colon stopping in the abdomen with no connection to the bottom, and everything in between. As a result, a child is unable to defecate (poop), which can result in an enlarged abdomen (abdominal distension).

The Pediatric Anorectal Continence Evaluation (PACE) Program treats more than 300 patients annually in our multidisciplinary clinic. We are experienced in diagnosis of anorectal malformations and tailor treatment to meet a child's specific needs. Comprehensive care for anorectal malformation includes colostomy surgery and surgical reconstruction using the pull-through procedure.

If there’s no opening at all, a child cannot pass stool and develops abdominal distension. This is an emergency that requires a diverting colostomy to bypass the obstruction. A colostomy brings a portion of the intestine to the abdominal wall and make an opening through which stool leaves the body into a colostomy bag. Growth is monitored carefully until patients are ready for the next stage of treatment, which typically includes a type of anorectal surgery called a pull-through procedure. Treatment may also include medications, diet, activity and lifestyle changes depending on a child's underlying diagnosis, associated anomalies and overall lifestyle.

Anorectal malformation is a lifelong condition that requires long-term follow-up to ensure a good outcome. CHOP’s PACE Program works with families to establish a successful bowel management program in the years following surgery so that a child may lead a normal, healthy life. Starting treatment early is important to help train the organs to function as normally as possible and maximize bowel control. At Children’s Hospital of Philadelphia, pediatric surgeons, advanced practice nurses, nutritionists, pediatric gastroenterologists, psychologists, social workers, and many other specialties help in the care of children with anorectal malformations.

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