Evolution of Anorectal Malformation Management and Validation of Krickenbeck Classification in Operated Cases

Abstract

Anorectal malformations (ARMs) comprise a wide spectrum of diseases that affect boys and girls and can involve malformation of the distal anus and rectum, as well as the urinary and genital tracts. Malformations of the distal anus and rectum, as well as the urinary and genital tracts. Malformations range from minor, easily treated defects that carry an excellent functional prognosis, to complex defects that are difficult to treat, are often associated with other anomalies, and carry a poor functional prognosis. ARMs are among the more frequent congenital anomalies encountered in paediatric surgery, with an estimated incidence ranging between 1 in 2000 and 1 in 5000 live births. ARMs are associated with a wide spectrum of other congenital abnormalities, with involvement of the genitourinary, spinal, cardiovascular, gastrointestinal, craniofacial and other systems. The classification of ARMs was based upon sex and the position of rectum relative to the levatorani muscle in high, intermediate and low (wingspread classification). Pena and colleagues suggested in the mid-90s a classification system based on the presence of a fistula. Key words: ARM, Pena, Krickenbeck classification