The position of the anal dimple in newborns and infants with anorectal malformations and its correlation with the normal anal position

The anal position index (API) defines the normal anal position as the ratio of fourchette–anal distance to fourchette–coccyx distance for females and the scrotum–anal distance to scrotum‐coccyx distance for males. In this study, measurement of the API in newborns and infants with anorectal malformat...

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Bibliographic Details
Published in:Journal of pediatric surgery 2018-08, Vol.53 (8), p.1560-1565
Main Authors: Patel, Jigar N., Kumar, Amit, Yadav, Partap Singh, Chadha, Rajiv, Datta, Vikram, Roy Choudhury, Subhasis
Format: Article
Language:English
Subjects:
Anal Canal - abnormalities
Anal Canal - anatomy & histology
Anal dimple
Anal position index
Anorectal malformation
Anorectal Malformations - diagnosis
Cloaca
Congenital pouch colon
Female
Humans
Infant
Infant, Newborn
Male
Perineum - abnormalities
Perineum - anatomy & histology
Prospective Studies
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Summary:The anal position index (API) defines the normal anal position as the ratio of fourchette–anal distance to fourchette–coccyx distance for females and the scrotum–anal distance to scrotum‐coccyx distance for males. In this study, measurement of the API in newborns and infants with anorectal malformations (ARM), using the center of the midline anal dimple (AD) to represent the center of the proposed neoanus, was performed to assess whether or not the AD was located in a significantly abnormal position as correlated with the normal anal position. The cases comprised 65 consecutive newborn and infants with ARM, divided into 2 age-based groups (Group A: 1st day to 1month; Group B: 1–12months), without sacral or significant perineal abnormalities. Controls included an equal number of age and gender matched patients admitted for other conditions. The characteristics of the AD (‘well developed’ or ‘moderately developed’) as well as those of the midline perineal raphé in males and the perineal groove in females were also recorded. Combining both age groups, the mean API±SD was 0.41±0.012 in male cases and 0.53±0.07 in male controls (p value 0.003). The corresponding values for female cases and controls were 0.31±0.09 and 0.36±0.07 respectively (p = 0.040). In male newborns, the API in cases was significantly lower than the API in controls (p
ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2017.11.043