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Surgery Pediatric Surgery 581c6beb

A newborn baby presents with absent anal orifice and meconuria. What is the most appropriate management:

A
Transverse colostomy
B
Conservative management
C
Posterior saggital anorectoplasty
D
Perineal V-Y plasty
High-Yield Explanation
The presence of meconium in urine reflects some form of communication between the urinary tract and rectum, and suggests a high type of anorectal malformation. Such patients require a diveing colostomy. The colostomy decompresses the bowel and provides protection during the healing of subsequent repair. Posterior Saggital Anorectoplasty (PSARP) is performed after 4-8 weeks. The presence of meconium in urine and a flat bottom are considered indications of a protective colostomy.

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