What are anorectal malformations (ARM)?
Congenital anomalies of anus and rectum with/without fistula
What is the most common ARM in males?
Anorectal atresia with rectourethral fistula
What is the most common ARM in females?
Rectovestibular fistula
What is the initial evaluation for ARM?
Perineal inspection, cross-table X-ray after 24 hrs
What imaging is used to assess rectal gas height in ARM?
Cross-table lateral radiograph
When is anoplasty performed in ARM?
If rectal gas is below coccyx or rectoperineal fistula is present
When is colostomy needed in ARM?
If rectal gas does not cross coccyx, or meconium in urine, or cloaca
What is the definitive surgery for high ARM?
Posterior sagittal anorectoplasty (PSARP) at 3–6 months
What are complications of ARM repair?
Wound infection, mislocated anus, rectal retraction, fistulas
