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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for anorectal malformation in newborn

sir, this is regarding my 2 1/2 year old male baby. he was born with ano-rectal mal formation (high type) with suspected rectovesical / rectourethral fistula and bifid scrotum. the child underwent loop colostomy on 3rd day of life (most proximal of sigmoid colon). further investigations revealed by (i)     MCU           : BILATERAL VESICO-URETHRAL REFLUX (GRADE I ON LT SIDE; GRADE II-III ON RT SIDE (ii)     DISTAL COLOGRAM : COLO-VESICAL FISTULA LEFT LATERAL WALL FURTHER, THE CHILD UNDERWENT AN OPERATION FOR FISTULA DISCONTINNUATION AND ABDOMINO PERINEAL PULL THROUGH AT THE AGE OF 7 MONTHS. FURHTER INVESTIGATIONS : (iii)     USG          : SMALL RT KIDNEY (iv)     RENOGRAM REPORT     : RT KIDNEY - MARKEDLY CONTRACTED /SMALL IN SIZE WITH NON FUNCTIONAL STATUS NOW THE CHILD HAS BEEN DIAGNOISED WITH VACTERL SYNDROME AND WAS ADVISED FOR MRI OF THE SPINE. (v)     MRI OF DORSO-LUMBAR SPINE : APLASIA OF THE PEDICLES OF L4 VERTEBRAL BODY WITH FUSION OF THE POSTERIOR ELEMENTS OF L3 AND L4 VERTEBRAE; LOW LYING CORD TERMINATING AT THE UPPER BORDER OF L3 VERTEBRAL BODY. CHILD S GROWTH IS NORMAL. WALKING, HT 86CMS, WT 13.6 KGS, STARTED TALKING. EXTERNAL APPEARENCE NORMAL. URINE AND STOOL PASSAGE NORMAL REQUEST FURTHER NECESSARY INTERVENTION.
Mon, 19 Oct 2020
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Pediatrician 's  Response
Hi,

After going through your child's notes, your child has got a rare type of syndrome called VACTERL syndrome. Apart from all the above anomalies which you have stated, he might also have tracheo- esophageal fistula (may be less danger type). Once, ask your consulting pediatrician about that. Your child's development in all spheres looks pretty good, but keep consulting your pediatrician for regular developmental assessment, renal, spine functions. Mostly, he will do well.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Lingamurthy Itha, Pediatrician
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Suggest treatment for anorectal malformation in newborn

Hi, After going through your child s notes, your child has got a rare type of syndrome called VACTERL syndrome. Apart from all the above anomalies which you have stated, he might also have tracheo- esophageal fistula (may be less danger type). Once, ask your consulting pediatrician about that. Your child s development in all spheres looks pretty good, but keep consulting your pediatrician for regular developmental assessment, renal, spine functions. Mostly, he will do well. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Lingamurthy Itha, Pediatrician