Adolescent anorectal malformations: Case series about 3 cases.

Introduction: Anorectal malformations (ARM) are an anatomically complex in which anorectum is either agenesic or communicates with neighboring organs. They are rarely found in adolescents. The aim of this study was to describe and discuss according to literature the three cases of ARM in adolescents.

Case presentation: There were three young girls who were 12, 17 and 18 years old, transferred to the department of surgery for investigation and management. One of them consulted for chronic constipation and the two others for recto-vestibular fistula. One patient was admitted with a left colostomy. For the two others, no previous surgery had been performed. The diagnosis was made after a review of the perineum. The treatment consisted of a lowering according to Peña. The postoperative course was uneventful. For the three cases, evaluation of their fecal continence by Hassink criteria was good after surgery. At up to 18 months later; those patients had presented no symptoms.

Clinical discussion: Each patient consulted with a specific complaint, including elimination of feces through the vagina and chronic constipation; clinical signs of associated malformations were absent in our patients. Clinical examination of the perineum allowed diagnosis and typing of ARM in these three patients.

Conclusion: Anorectal malformations should be diagnosed during the first examination of a newborn. The presence of a large fistula represents a trap that often laid to late diagnosis in children and teenager suffering from chronic constipation evolving since birth.