Anal area covered with skin

Introduction The diagnosis of anal atresia is no meconium discharge after birth, the anal area is covered with skin, and the anal area has a sense of impact when crying. Anal atresia (alal atresia), also known as low anorectal atresia, due to abnormal primordia anal development, did not form anal canal, resulting in the rectum and the outside world. In Chinese medicine, it is called "anal closure."

Cause

Causes:

Anal atresia is a median malformation, which is common in clinical practice. It is due to primitive anal developmental disorders, and it does not form an anal canal to form a deformity. The rectal development is basically normal, and the blind end is at the edge of the urethral bulb sponge, or near the lower end of the vagina, and the puborectalis muscle surrounds the distal rectum. The perineum is often stunted and flat, and the anal area is covered with intact skin.

an examination

Related inspection

Anal finger examination anal inspection

Clinical examination:

No meconium is discharged after birth, the anal area is covered with skin, and the anal area has a shock when crying. Inverted position on the X-ray lateral slice, the end of the rectum is located on the shame line or slightly below it. Ultrasound and puncture method measured the blind end of the rectum to about 1.5cm from the skin of the anus.

After the birth of the child, no meconium was discharged, and symptoms such as vomiting and abdominal distension were soon found. Local examination showed that the center of the perineum was flat, and the part of the anus was covered with skin. In some cases, there is a pigmentation with obvious depressions and radiation wrinkles, which stimulate the ring muscle contraction reaction. When the baby is crying or holding his breath, there is a protrusion in the center of the perineum. The finger can be placed in the area to have a sense of impact. The baby is placed in the low position of the hip and the lower part of the anus is diagnosed as a drum sound.

Differential diagnosis

The anal area is a differential diagnosis of skin coverage:

1. Congenital intestinal atresia and stenosis: Intestinal tube development during embryonic stage, part of the intestinal tract is terminated during revascularization, resulting in complete or partial obstruction of the intestinal lumen. Complete blockage is occlusion and partial blockage is stenosis. It can occur in any part of the intestine, but it is most common in the ileum, followed by the duodenum, and the colon is rare. It is one of the common causes of intestinal obstruction in newborns.

2. Intestinal stenosis: Intestinal atresia and intestinal stenosis are common congenital gastrointestinal malformations in neonatal intestinal obstruction, which can occur in any part of the intestine. The jejunum and ileum are more common, followed by the duodenum, and the colon is rare.

3. Intestinal obstruction: Intestinal obstruction (ileus) means that the contents of the intestine are blocked in the intestine. For common acute abdomen, it can be caused by many factors. At the beginning of the onset, the obstructed intestine segment has anatomical and functional changes first, followed by loss of body fluids and electrolytes, intestinal wall dysfunction, necrosis and secondary infection, and finally can cause toxemia, shock, and death. Of course, if timely diagnosis and active treatment can mostly reverse the development of the disease, it will cure.

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