What Is Atresia Ani?

Atresia ani or also called imperforate anus is one type of birth defect that occurs when the gestational age reaches 5 to 7 weeks, in which the development of the rectum ( the final part of the large intestine ) to the anus is not perfect. This condition occurs in 1 in 5,000 infants, and is a serious condition that need to be treated promptly with surgery.

There are several forms of atresia ani, as follows:

• The anus holes are narrowed or completely closed.
• Formation of fistulas or ducts that connect the rectum with the bladder, urethra, base of the penis, or vagina.
• The rectum is not connected to the colon.

Causes of Atresia Ani
Under normal conditions, the anus, fetal, and fetal sex ducts are formed at seven to eight weeks' gestation through the process of cleavage and separation of the fetal digestive wall. Disorders during this fetal development will cause atresia ani.

The cause behind this developmental disorder is not known for certain. Experts suspect that there is a genetic or genetic involvement behind the occurrence of this birth defect.

Symptoms of Atresia Ani
Infants born with atresia ani condition generally have symptoms and clinical signs as follows:

• The anus hole is very close to the vagina in the baby girl.
• The anus hole is not where it should be, or there is no anal opening at all.
• The first stool does not come out within 24-48 hours after birth.
• Stool out of the vagina, the base of the penis, scrotum, or urethra.
• Stomach enlarged.

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Diagnosis of Atresia Ani
Atresia ani is commonly known at the first physical examination performed when the baby is born. The doctor will examine all parts of the body of the newborn baby, from head to foot. When atresia ani is discovered, the doctor will then confirm whether there are other types of abnormalities that are also experienced by the baby.

Atresia ani is a congenital or congenital abnormality that occurs due to a fetal developmental disturbance. In addition to atresia ani, some of them also have abnormalities associated with developmental disorders while still in the womb, such as:

• Abnormalities in the urinary tract and kidney.
• Abnormalities in the spine.
• Abnormalities in the respiratory tract.
• Abnormalities in the esophagus.
• Abnormalities in the arms and legs.
• Down syndrome.
• Congenital heart disease .
• Hirschsprung's disease .
• Duodenal atresia (abnormalities of the small intestine).

To find out other abnormalities associated with atresia ani, the doctor will perform follow-up tests, such as:

• X-ray, to detect if there are bone abnormalities.
• Ultrasound of the spine.
• MRI, to check the condition of the esophagus, throat, and related organs.
• Echocardiography , to check the condition of the heart.

Treatment of Anesia Atresia
Infants who do not have an anal canal will be fed intravenously. If there is a fistula formed in the urinary tract, the doctor will give antibiotics.

In order for the gastrointestinal tract to run normally, atresia ani should be corrected by surgery. However, determining the exact moment when different surgery is performed on each baby depends on the type and complexity of the atresia ani form that occurs as well as the health condition of the baby itself, given that half of the anion's atres sufferers also have other congenital abnormalities. The life-threatening situation will be dealt with first. If surgical repair actions can not be done, the doctor will make a colostomy, which is making a hole (stoma) in the abdominal wall as a temporary drain. This hole will be connected to the intestine, and the stool coming out of the stoma will be accommodated in a bag called the colostomy bag .

The type of repair surgery performed depends on the type of atresia ani. For example, the doctor will perform an action called perineal anoplasty, which closes the fistula connected with the urinary tract or vagina, and will make the anus in the position where it should be. The success of surgery in repairing atresia ani can be said to be good, although sometimes it does not require only one operation.

Complications of Ani Atresia
Some complications that can occur after the repair surgery performed, among others:

• Constipation . Constipation can be overcome with a high fiber diet. Purgatives are also sometimes given to prevent the accumulation of stools in the intestine, which will make the intestine widen and cause the movement to be reduced.
• Stool or urine incontinence . Stool or urine incontinence may occur, although surgery is smooth and uncomplicated.
• Anal stenosis . The new anus may form scar tissue and narrow (stenosis). When this happens, it will require further operation. To prevent anal stenosis, the physician will perform and teach the patient's parents to perform new stretching or stretching of the anal anus regularly (anal dilatation).

In addition to postoperative complications, complications may also occur prior to surgery, including intestinal rupture (perforation), or urinary tract infection if there is a fistula to the urinary tract.

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