Successful management without protective colostomy in an adult patient with anorectal mal-formation

Abstract

Anorectal malformations are rare occurrences characterized by the absence or abnormal localization of the anus. Clinical manifestations can vary from mild forms that require only minor surgery to more complicated cases that must be managed with multi-staged surgery. In this report, our aim is to present the clinical characteristics, management, and treatment outcome of an adult patient with an anorectal malformation with a vestibular fistula that was successfully repaired by posterior sagittal anorectoplasty (PSARP) and to discuss the case in the light of the relevant literature. We also would like to underline the fact that primary anorectal malformations can, although rarely, be observed in adult patients. A 26-year-old female patient presented with an imperforate anus and constipation with feces passing through a fistula located at the distal part of her vagina. She was continent for solid feces, but had leakage of flatus and fecal soiling. She also had concurrent left renal agenesis. A posterior sagittal anorectoplasty was successfully performed without a colostomy. The patient was discharged uneventfully on the postoperative 8th day. The patient was fully continent during a control visit after seven years of follow-up. Posterior sagittal anorectoplasty is a technique that can be successfully used in adult patients with anorectal malformations.