Етапне хірургічне лікування аноректальної атрезії, асоційованої з атрезією товстої кишки ІІ типу та аномаліями сечовивідної системи, у новонародженого хлопчика (клінічне спостереження та огляд літератури)

Abstract

Anorectal malformation is a congenital anomaly and can be either isolated or associated. This malformation is often combined with other congenital defects, in particular VACTERL-association (anomalies of the spine, anal region, heart, trachea, esophagus, kidneys and extremities), which requires a comprehensive diagnosis in these patients. Congenital malformations of the gastrointestinal tract except for esophageal atresia are rare. The paper presents a clinical case of associated congenital anomalies of the gastrointestinal tract and urinary system in a newborn boy: congenital anorectal malformation without fistula, type II sigmoid atresia with bowel malrotation, vesicoureteral reflux, right-sided pyelectasia and coronal hypospadias. Comprehensive diagnostics before each stage of surgical treatment made it possible to determine the method and technique of surgical correction. This made it possible to preserve a part of the intestine which was presented in the form of an enterocyst to create a neorectum as well as to diagnose the functional incompetence of the preatritic segment of the colon and carry out its removal. Atresia of the sigmoid colon is not a common concomitant malformation in congenital anorectal malformation, but it should be taken into account in the differential diagnosis in newborns with progressive abdominal distension and anorectal atresia without fistula. The proposed staging of the surgical management of these associated malformations should be regarded as organ-preserving, allowing to restore the normal function of the gastrointestinal tract and urinary system, with a good functional result. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. The authors declare no conflicts of interests. Key words: anorectal atresia without fistula, sigmoid atresia, vesicoureteral reflux, coronary hypospadias, surgical management, newborn boy.