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Clinical Differentiation between a Normal Anus, Anterior Anus, Congenital Anal Stenosis, and Perineal Fistula: Definitions and Consequences—The ARM-Net Consortium Consensus

In the past, an anteriorly located anus was often misdiagnosed and treated as an anorectal malformation (ARM) with a perineal fistula (PF). The paper aims to define the criteria for a normal anus, an anterior anus (AA) as an anatomic variant, and milder types of ARM such as congenital anal stenosis...

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Autores principales: Amerstorfer, Eva E., Schmiedeke, Eberhard, Samuk, Inbal, Sloots, Cornelius E. J., van Rooij, Iris A. L. M., Jenetzky, Ekkehart, Midrio, Paola
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9221870/
https://www.ncbi.nlm.nih.gov/pubmed/35740768
http://dx.doi.org/10.3390/children9060831
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author Amerstorfer, Eva E.
Schmiedeke, Eberhard
Samuk, Inbal
Sloots, Cornelius E. J.
van Rooij, Iris A. L. M.
Jenetzky, Ekkehart
Midrio, Paola
author_facet Amerstorfer, Eva E.
Schmiedeke, Eberhard
Samuk, Inbal
Sloots, Cornelius E. J.
van Rooij, Iris A. L. M.
Jenetzky, Ekkehart
Midrio, Paola
author_sort Amerstorfer, Eva E.
collection PubMed
description In the past, an anteriorly located anus was often misdiagnosed and treated as an anorectal malformation (ARM) with a perineal fistula (PF). The paper aims to define the criteria for a normal anus, an anterior anus (AA) as an anatomic variant, and milder types of ARM such as congenital anal stenosis (CAS) and PF. An extensive literature search was performed by a working group of the ARM-Net Consortium concerning the subject “Normal Anus, AA, and mild ARM”. A consensus on definitions, clinical characteristics, diagnostic management, and treatment modalities was established, and a diagnostic algorithm was proposed. The algorithm enables pediatricians, midwives, gynecologists, and surgeons to make a timely correct diagnosis of any abnormally looking anus and initiate further management if needed. Thus, the routine physical inspection of a newborn should include the inspection of the anus and define its position, relation to the external sphincter, and caliber. A correct diagnosis and use of the presented terminology will avoid misclassifications and allow the initiation of correct management. This will provide a reliable comparison of different therapeutic management and outcomes of these patient cohorts in the future.
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spelling pubmed-92218702022-06-24 Clinical Differentiation between a Normal Anus, Anterior Anus, Congenital Anal Stenosis, and Perineal Fistula: Definitions and Consequences—The ARM-Net Consortium Consensus Amerstorfer, Eva E. Schmiedeke, Eberhard Samuk, Inbal Sloots, Cornelius E. J. van Rooij, Iris A. L. M. Jenetzky, Ekkehart Midrio, Paola Children (Basel) Article In the past, an anteriorly located anus was often misdiagnosed and treated as an anorectal malformation (ARM) with a perineal fistula (PF). The paper aims to define the criteria for a normal anus, an anterior anus (AA) as an anatomic variant, and milder types of ARM such as congenital anal stenosis (CAS) and PF. An extensive literature search was performed by a working group of the ARM-Net Consortium concerning the subject “Normal Anus, AA, and mild ARM”. A consensus on definitions, clinical characteristics, diagnostic management, and treatment modalities was established, and a diagnostic algorithm was proposed. The algorithm enables pediatricians, midwives, gynecologists, and surgeons to make a timely correct diagnosis of any abnormally looking anus and initiate further management if needed. Thus, the routine physical inspection of a newborn should include the inspection of the anus and define its position, relation to the external sphincter, and caliber. A correct diagnosis and use of the presented terminology will avoid misclassifications and allow the initiation of correct management. This will provide a reliable comparison of different therapeutic management and outcomes of these patient cohorts in the future. MDPI 2022-06-03 /pmc/articles/PMC9221870/ /pubmed/35740768 http://dx.doi.org/10.3390/children9060831 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Amerstorfer, Eva E.
Schmiedeke, Eberhard
Samuk, Inbal
Sloots, Cornelius E. J.
van Rooij, Iris A. L. M.
Jenetzky, Ekkehart
Midrio, Paola
Clinical Differentiation between a Normal Anus, Anterior Anus, Congenital Anal Stenosis, and Perineal Fistula: Definitions and Consequences—The ARM-Net Consortium Consensus
title Clinical Differentiation between a Normal Anus, Anterior Anus, Congenital Anal Stenosis, and Perineal Fistula: Definitions and Consequences—The ARM-Net Consortium Consensus
title_full Clinical Differentiation between a Normal Anus, Anterior Anus, Congenital Anal Stenosis, and Perineal Fistula: Definitions and Consequences—The ARM-Net Consortium Consensus
title_fullStr Clinical Differentiation between a Normal Anus, Anterior Anus, Congenital Anal Stenosis, and Perineal Fistula: Definitions and Consequences—The ARM-Net Consortium Consensus
title_full_unstemmed Clinical Differentiation between a Normal Anus, Anterior Anus, Congenital Anal Stenosis, and Perineal Fistula: Definitions and Consequences—The ARM-Net Consortium Consensus
title_short Clinical Differentiation between a Normal Anus, Anterior Anus, Congenital Anal Stenosis, and Perineal Fistula: Definitions and Consequences—The ARM-Net Consortium Consensus
title_sort clinical differentiation between a normal anus, anterior anus, congenital anal stenosis, and perineal fistula: definitions and consequences—the arm-net consortium consensus
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9221870/
https://www.ncbi.nlm.nih.gov/pubmed/35740768
http://dx.doi.org/10.3390/children9060831
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