Leading symptoms of anorectal malformation in the
neonatal period are abdominal distention, non-passage of
meconium and constipation. When present, vomiting is a
late symptom. In a study in Calabar, Nigeria, patients were
observed to present late, and teenage mothers in rural
communities were mostly affected. Female neonates were
affected more than males in a ratio of 1.5:1. Classification
into low and high abnormality was adopted and proved
practical in terms of identification of the pathology and
treatment of the lesion. Patients with low abnormality
(N = 24, 44.4%) were treated with perineal cut-down, while
those with high abnormality (55.6%) had initial palliative
colostomy before a definitive abdominal perineal pullthrough
procedure. Faecal incontinence (13%), anal
stenosis (11.1%), constipation (7.4%) and colostomy prolapse
(5.6%) were noted to be associated complications.
Poverty and ignorance were noted to be the main factors
affecting treatment outcome. A concerted public
enlightenment campaign is therefore required.