In the past, an anteriorly located anus was often misdiagnosed and treated as an anorectal malformation (ARM) with a perineal fistula (PF). The paper aims to define the criteria for a normal anus, an anterior anus (AA) as an anatomic variant, and milder types of ARM such as congenital anal stenosis (CAS) and PF. An extensive literature search was performed by a working group of the ARM-Net Consortium concerning the subject "Normal Anus, AA, and mild ARM". A consensus on definitions, clinical characteristics, diagnostic management, and treatment modalities was established, and a diagnostic algorithm was proposed. The algorithm enables pediatricians, midwives, gynecologists, and surgeons to make a timely correct diagnosis of any abnormally looking anus and initiate further management if needed. Thus, the routine physical inspection of a newborn should include the inspection of the anus and define its position, relation to the external sphincter, and caliber. A correct diagnosis and use of the presented terminology will avoid misclassifications and allow the initiation of correct management. This will provide a reliable comparison of different therapeutic management and outcomes of these patient cohorts in the future.
Clinical Differentiation between a Normal Anus, Anterior Anus, Congenital Anal Stenosis, and Perineal Fistula: Definitions and Consequences-The ARM-Net Consortium Consensus / Amerstorfer, Eva E; Schmiedeke, Eberhard; Samuk, Inbal; Sloots, Cornelius E J; van Rooij, Iris A L M; Jenetzky, Ekkehart; Midrio, Paola; Aminoff, ; D., Bagolan; P., Iacobelli; B. de Blaauw, I.; van der Steeg, Herjan; Broens, P.; Çavuşoğlu, H.; Deluggi, S.; Ludwiczek, J.; Divarci, E.; Fanjul, M.; Fascetti-Leon, F.; García Vázquez, A.; Giné, C.; Giuliani, S.; Gorter, R.; Goseman, J.; Lacher, M.; Grano, C.; Grasshoff-Derr, Buergerhospital; Holland-Cunz, S.; Justin de, Jong; Leva, E.; Morandi, A.; Lisi, G.; Makedonsky, ; I., Carlo Marcelis; Marc, Miserez; Mazeena, Mohideen; Onur, Ozen; Alessio Pini, Prato; Carlos, Reck-Burneo; Heiko, Reutter; Stephan, Rohleder; Nicole, Schwarzer; Pernilla, Stenström; Holger, Till; Chris, Verhaak; Alejandra, Vilanova-Sánchez; Patrick, Volk; Marieke, Witvliet. - In: CHILDREN. - ISSN 2227-9067. - 9:6(2022), p. 831. [10.3390/children9060831]
Clinical Differentiation between a Normal Anus, Anterior Anus, Congenital Anal Stenosis, and Perineal Fistula: Definitions and Consequences-The ARM-Net Consortium Consensus
Grano C.;
2022
Abstract
In the past, an anteriorly located anus was often misdiagnosed and treated as an anorectal malformation (ARM) with a perineal fistula (PF). The paper aims to define the criteria for a normal anus, an anterior anus (AA) as an anatomic variant, and milder types of ARM such as congenital anal stenosis (CAS) and PF. An extensive literature search was performed by a working group of the ARM-Net Consortium concerning the subject "Normal Anus, AA, and mild ARM". A consensus on definitions, clinical characteristics, diagnostic management, and treatment modalities was established, and a diagnostic algorithm was proposed. The algorithm enables pediatricians, midwives, gynecologists, and surgeons to make a timely correct diagnosis of any abnormally looking anus and initiate further management if needed. Thus, the routine physical inspection of a newborn should include the inspection of the anus and define its position, relation to the external sphincter, and caliber. A correct diagnosis and use of the presented terminology will avoid misclassifications and allow the initiation of correct management. This will provide a reliable comparison of different therapeutic management and outcomes of these patient cohorts in the future.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
