Abstract
BackgroundTeenage and late presentation of anorectal malformations are not uncommon in developing world. Some of the reasons for late presentation include but not limited to illiteracy, poverty, lack of awareness, and limited trained pediatric surgeons. In rural areas, neonates with ARMs are considered cursed and are marginalized.Case15-Year-old African girl (a munyankole by tribe in Uganda) from western Uganda presented at 15 years of life with colostomy and uncorrected anorectal malformation. Never went to school due to social stigma.ConclusionDue to limited number of trained pediatric surgeons in most of African Countries, many children in addition to living with a colostomy or untreated malformation, may also be undiagnosed with chronic constipation. Improved awareness and advocacy would promote early presentation and treatment.
Highlights
Anorectal malformations (ARMs) are common congenital anomalies with a reported incidence of approximately 1 in 5000 live births [1]. They have been classified according to Krickenbeck classification [2, 3]
At the time of presentation, she was a well-nourished teenage girl with evident secondary female characteristics, weighing 53 kg, Abdominal examination was normal with a well-functioning double barrel sigmoid colostomy
Our patient lived with colostomy because of lack of awareness of her grandmother when she lost her parents
Summary
Due to limited number of trained pediatric surgeons in most African countries, as well as low community awareness about the possibility of definitive repair, many children live with a colostomy or untreated malformation. As a result, they often have undiagnosed chronic constipation and fecal incontinence. Result in significant social ostracization and limited ability to go to school. Improved awareness and advocacy would promote early presentation and treatment
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