INTRODUCTION

MANAGEMENTS

PATHOPYSIOLOGY

SOURCES
SIGN & SYMPTOMS
IMPERFORATE ANUS
• A stricture of the anus
• Week 7 of intrauterine life: Upper bowel
elongates and combines with a pouch
invaginating from the perineum.
• Two sections of bowel meet; membranes
between them dissolve, allowing bowel to
be patent to the outside.
• Failure of motion toward each other or non
-dissolution of the membrane results in
imperforate anus.
 Gloved finger or thermometer
cannot be inserted into infant
Genetic and rectum
Environmental Factors
No history of passage of meconium

Detection at
Birth
Presence of abdominal distension

Presence of meconium in urine,

Cloacal Membrane
Incomplete Cloacal indicating rectovaginal fistula
Abnormalities
Partitioning
No anal opening

Early sign and Infants failing to pass

symptoms stools within the first 24
hours should prompt
investigation.
Imperforate
anus
 • a “wink” reflex will not be present if
sensory nerve endings in the rectum are

ASSESSMENT
not intact.

If these methods fail to detect the condition, it

can be discovered in a newborn by
• the inability to insert a rubber catheter into
the rectum.
• radiograph or sonogram
 Traditional Hospital Stay

•Previously, newborns stayed in the hospital for 3

to 4 days post-birth, allowing for thorough

ASSESSMENT
assessment.

Follow-up assessments infant born in a birthing

center or at home should include:
•monitoring stool passage
•Collection of urine specimen for meconium
examination in infants suspected of imperforate
anus.
•Use of urine collector bags in girls to detect
meconium-stained discharge or rectovaginal fistula.
 • Imperforate anus is discovered at birth
when inspection of a newborn’s anal
Current Practices
region reveals that no anus is present.

ASSESSMENT
• a “wink” reflex (touching the skin near
• there would the
be arectum
decreaseshould make it contract)
opportunitieswill
for not
earlybedetection
present if sensory nerve
and the Lack of stool passage
endings in the rectum are not intact.
may be missed without diligent
follow-up.
If these methods fail to detect the
condition, it can be discovered in a newborn
by
the inability to insert a rubber catheter
into the rectum. No stool will be passed,
and abdominal distention will become
evident.
radiograph or sonogram
 THERAPEUTIC MANAGEMENT

Anastomosis of the
separated bowel
segments
If the rectum ends
close to the
perineum (below or
at the level of the
levator ani muscle)
and the anal
sphincter is formed
 THERAPEUTIC MANAGEMENT
The repair becomes
Anastomosis of the complicated if
separated bowel the end of the rectum is
segments at a distance from the
If the rectum ends perineum (above the
close to the levator ani muscle) or the
perineum (below or anal sphincter exists only
at the level of the in an underdeveloped
levator ani muscle) form. All repairs are
and the anal complicated if a fistula to
sphincter is formed the bladder or vagina is
present.
 THERAPEUTIC MANAGEMENT
The repair becomes
Anastomosis of the complicated if
separated bowel the end of the rectum is
segments at a distance from the
If the rectum ends perineum (above the
close to the levator ani muscle) or the
perineum (below or anal sphincter exists only
at the level of the in an underdeveloped
levator ani muscle) form. All repairs are
and the anal complicated if a fistula to
sphincter is formed the bladder or vagina is
present.
If the repair will be
extensive
the surgeon may
create a temporary
colostomy,
anticipating final
repair when the
infant is somewhat
older (6 to 12
months).
 THERAPEUTIC MANAGEMENT
The repair becomes
Anastomosis of the
complicated if
separated bowel
the end of the rectum is
segments
at a distance from the
If the rectum ends
perineum (above the
close to the
levator ani muscle) or the
perineum (below or
anal sphincter exists only
at the level of the
in an underdeveloped
levator ani muscle) form. All repairs are
and the anal complicated if a fistula to
sphincter is formed the bladder or vagina is
present.
If the repair will be
For a successful repair
extensive
it is unnecessary for
the surgeon may
an internal rectal
create a temporary
sphincter to be
colostomy,
present as long as the
anticipating final
subrectal muscle is
repair when the
judged to be intact.
infant is somewhat
older (6 to 12
months).
 THERAPEUTIC MANAGEMENT
The repair becomes
Anastomosis of the
complicated if
separated bowel
the end of the rectum is
segments
at a distance from the
If the rectum ends
perineum (above the
close to the
levator ani muscle) or the
perineum (below or
anal sphincter exists only
at the level of the
in an underdeveloped
levator ani muscle) form. All repairs are
and the anal complicated if a fistula to
sphincter is formed the bladder or vagina is
present.
If the repair will be
For a successful repair
extensive
it is unnecessary for
the surgeon may
an internal rectal
create a temporary
sphincter to be
colostomy,
present as long as the
anticipating final
subrectal muscle is
repair when the
judged to be intact.
infant is somewhat
older (6 to 12
months).
REFERENCES
Pillitteri, Adele., (2010). Maternal and child
health nursing: care of the childbearing and
childrearing family-6th ed. pg 168-170.

https://www.parents.com/
baby/development/social/
decode-your-babys-body-
language/
https://
www.medicalnewstoday.com/
THANK
YOU!!!