Congenital rectal and anal canal anomalies

　　The occurrence of rectal and anal anomalies is the result of developmental disorders during the embryonic period, and the incidence in males and females is basically the same, with only anatomical differences resulting from the separation process of the cloaca. The communication between the urogenital sinus and the anal-rectal sinus forms high or intermediate position anomalies, leading to various incomplete anal-rectal developments, fistulas between the rectum and the urethra or vagina, posterior anal process disorders, and incomplete perineal development, resulting in low position anomalies, anal skin fistulas, anterior anal fossa fistulas, anal stenosis, and so on.

　　Congenital rectal and anal canal anomalies are digestive tract anomalies caused by developmental disorders of the posterior intestine during the embryonic period.

　　Complications of congenital rectal and anal canal anomalies

　　In children with urinary system infection, high or levator ani anomalies, accompanied by urinary system fistulas, recurrent urethritis, balanitis, and upper urinary tract infection may occur.

　　In patients with high urinary and fecal incontinence or recto-anal muscle anomalies above the levator ani, combined with spinal anomalies, if the sacral nerve is involved, urinary and fecal incontinence may occur due to the innervation of the bladder and anal sphincter muscles by its branches.

　　3. Girls with vaginal vestibular fistula due to vaginitis often have feces flowing out of the vestibular fistula.

　　1. Most children with congenital rectal anal atresia do not have an anus in the normal position and are easy to detect. Rectal anal atresia without fistula manifests as no meconium excretion, abdominal distension, and vomiting shortly after birth; the narrow fistula orifice cannot excrete meconium or can only excrete a small amount of meconium, the child vomits after feeding, and then gradually develops abdominal distension; the larger fistula orifice. For a period of time after birth, there may be no symptoms of intestinal obstruction, but difficulties in defecation will gradually appear in a few weeks to several years. High rectal atresia, where the anus and anal canal are normal, manifests as no meconium excretion, or turbid fluid excreted from the urethra, rectal examination can find rectal atresia.

　　2. Girls often have vaginal fistulas.

　　3. Urinary fistula is almost always seen in boys.

　　4. Exuding gas from the urethral orifice and meconium are the main symptoms of rectal urinary system fistula.

　　Believed to be related to viral infection during the early stages of pregnancy, high fever, medication, radiation exposure, allergies, low immune response, and certain genetic genes, especially good care of prenatal health and genetic counseling should be done. Methods to avoid and prevent genetic diseases:

　　1. Avoiding consanguineous marriage:The children born from consanguineous marriages have much lower intelligence than those from non-consanguineous marriages, and the incidence rate is very high. Therefore, it is necessary to avoid consanguineous marriage.

　　2. Pre-marital counseling:If either both or one of the partners has a family member with a genetic disease, and worries about giving birth to a child with the same genetic disease after marriage, they should consult whether they can get married and whether the consequences after marriage will be serious; if one of the partners has a certain disease but is not sure whether it is a genetic disease, whether they can get married, and what are the chances of passing it on to offspring? Doctors will make an explicit diagnosis and inform of reasonable treatment methods.

　　3. Avoiding late pregnancy:It is best not to exceed 35 years of age during the childbearing age, because the cells of elderly pregnant women age, are susceptible to external viral infections, and the offspring formed after fertilization are prone to chromosomal diseases.

　　4. Conducting fertility counseling:Whether the same situation will occur again if you have given birth to a child with low intelligence or a disabled child, or if the child died prematurely due to illness; whether a woman with a history of habitual abortion can give birth again, and how to prevent it; whether the fetus will be affected if a woman has been sick during pregnancy, taken certain drugs, been exposed to chemical toxins, or worked in a position with radioactive contamination. Through consultation, doctors will perform necessary checks on both partners and provide treatment methods and accurate advice.

　　5. Consultation with administrative departments:The health administration department or family planning department consults medical geneticists when drafting relevant eugenic policies, such as: whether the formulation of certain eugenic regulations and regulations is reasonable; what countermeasures should be taken to control common genetic diseases in a region; how to conduct investigations of certain genetic diseases, etc. Therefore, newlyweds should consult relevant administrative departments.

　　6. Termination of pregnancy:If you are pregnant and have been diagnosed with a serious illness, terminate the pregnancy as soon as possible.

　　1. Imaging examination:The diagnosis of congenital anorectal malformations is not difficult, but to determine the height of rectal atresia, the relationship between the rectal end and the puborectalis muscle, and whether there is a urinary tract fistula, imaging examination is still needed.

　　2. Inverted X-ray filming method:It can understand the position of the rectal end gas shadow and judge the position of the malformation. The line connecting the pubic symphysis and the sacrococcygeal joint on the inverted lateral film is called the Pc line, which is equivalent to the puborectalis muscle plane, and is used to distinguish between high, middle, and low malformations.

　　3. Fistula angiography:It can show the direction, length, and thickness of the fistula.

　　4. Rectal blind end puncture angiography:It can show the shape of the rectal blind end and the distance from the perineal skin. Ultrasound examination is more accurate in locating the rectal end than X-ray.

　　5. Magnetic Resonance Imaging (MRI):It is also being used in clinical practice and is accurate and reliable.

　　First, it is forbidden to drink alcohol during pregnancy.

　　When pregnant women drink alcohol, alcohol can pass through the placenta to enter the developing embryo and cause serious damage to the fetus. Drinking more than 2 cups of alcohol a day during pregnancy can affect the fetus and even be dangerous; drinking 2 to 4 cups a day has the risk of malformation development. Such as very small head, extremely small nose and ears, and thick upper lip.

　　Second, coping methods:

　　1. Quit drinking;

　　2. Must quit drinking;

　　3. Absolutely must quit drinking.

　　During pregnancy, it is forbidden to consume moldy food.

　　Experts point out that if pregnant women consume food contaminated with mycotoxins (moldy food), mycotoxins can pass through the placenta to harm the fetus, causing cell chromosome breakage in the fetus's body, resulting in congenital malformations.

　　All require surgical treatment. Rectovesical fistula is often accompanied by urinary tract infection and should be operated on early. Other types of fistula can be operated on after 3 to 5 years if defecation is smooth. The fistula tube is excised through the abdomen or perineum, the rectum is pulled down and sutured in place at the original anus, or an anal sphincteroplasty is performed. Since it is a superficial malformation, it is easy to diagnose. In addition to clinical examination, it is necessary to further measure the distance between the rectal blind end and the levator ani plane and the anal skin to determine the type of malformation, the position of the fistula, and the associated malformations, so that appropriate treatment methods can be selected.