Clinical Quiz—Newborn Female with an Anorectal Malformation and a Gynecological Abnormality

Infographic · Jul 2022 · 1 min read

In brief

Interactive clinical case of a newborn with imperforate anus, vestibular fistula, and absent vaginal opening requiring diagnostic laparoscopy. Quiz-format presentation explores surgical decision-making when anorectal malformations coexist with Mullerian duct anomalies in female neonates.

Imperforate anus in females requires careful perineal exam to identify fistula location and assess for concurrent gynecological anomalies.
Vestibular fistula with absent vaginal opening suggests Mullerian anomaly; diagnostic laparoscopy clarifies internal pelvic anatomy.
Surgical planning for anorectal malformation must account for coexisting urogenital abnormalities to avoid iatrogenic injury.
Normal urethral anatomy does not exclude complex pelvic malformations; systematic evaluation of all three perineal openings is essential.
Mullerian anomalies occur in subset of female ARM patients; multidisciplinary approach with gynecology improves long-term outcomes.

Written by the GCMD Library team from the infographic.

A vertical flowchart with four stages connected by arrows, using blue color scheme. Each stage contains circular or rounded elements with medical illustrations of anatomical findings. The layout progresses from initial clinical exam through intraoperative findings, laparoscopy results, to final surgical approach. Small anatomical diagrams appear in the laparoscopy and surgical approach sections.

We present a case of a newborn female with imperforate anus who on exam was found to have a rectal fistula in the vestibule, no vaginal opening, and a normal urethra. A diagnostic laparoscopy was performed to elucidate the internal anatomy. The case is presented with a focus on surgical strategies in approaching the female patient with anorectal malformation and a Mullerian anomaly, with questions for the readers posed in a quiz format.

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