Abstract
Two cases of hyperchloremic acidosis occurring as a complication in infants with high Type III imperforate anus and rectourinary fistula have been reported and discussed. The possibility of this complication of electrolyte imbalance occurring where a colostomy, a fistula and urinary infection are present has been stressed. Factors in the pathogenesis of hyperchloremic acidosis have been outlined in relation to the anatomic abnormalities present in imperforate anus. Particular emphasis has been laid on the recto-urinary fistula through which retrograde flow of urine occurs into the large distal colostomy loops. While control of the imbalance can be helped by vigorous intravenous therapy, combined with an indwelling catheter, definitive treatment consists of elimination of the fistula surgically, either as a separate procedure or as part of an abdominoperineal pull-through.
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