Rare case report of anorectal malformation and intestinal atresia

• Published in: International journal of surgery case reports Vol. 82; p. 105945
• Main Authors: Gunderson, Emily J., Sacks, Marla A., Goodman, Laura F., Hashmi, Asra, Radulescu, Andrei, Khan, Faraz A.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.05.2021; Elsevier
• Subjects: Anorectal malformation; Case Report; Intestinal atresia; Prenatal diagnosis; PSARP; TPN; Prenatal diagnosis; Intestinal atresia; IFALD; NICU; VACTERL; ARM; Anorectal malformation
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2021.105945

Intestinal malformations, such as intestinal atresia, malrotation, and anorectal malformation, are rare events, but concurrent intestinal atresia and anorectal malformation are rare in combination. These anomalies have similar in utero and perinatal symptoms, which can make the diagnosis of both defects prenatally challenging. We present a case of a male infant with a prenatal diagnosis of truncus arteriosus who on a 32-week routine prenatal ultrasound was suspected to have an intestinal malformation. On day of life one, the patient was taken to the operating room and found to have both type IIIa ileal atresia and anorectal malformation with normal bowel in between. A complete work up for vertebral defects, anorectal malformation, cardiac septal defects, esophageal atresia, renal anomalies, and radial limb defects (VACTERL) anomalies did not reveal additional anomalies. In this case, prenatal information supported intestinal obstruction, and the rare combination of both intestinal atresia and anorectal malformation proved surprising and interesting. We suggest providers be aware of the potential of multiple alimentary tract malformations to improve operative preparation and reduce the morbidity or mortality risk from repeat procedures when possible. •The combination of anorectal malformation and intestinal atresia is exceedingly rare.•This unique combination was found in a twin with the other twin having a normal intestinal tract.•A VACTERL workup is key to rule out other malformations.