Incidence and spectrum of anorectal malformations in Western Saudi Arabia

OBJECTIVES: To present the incidence and spectrum of anorectal malformations (ARMs) and associated anomalies and to compare the findings with published literature.

METHODS: This is a retrospective study conducted during the period January 2011 to December 2011. We reviewed the medical charts of all cases with ARMs admitted at Al-Madinah Maternity and Children Hospital, Madinah, Kingdom of Saudi Arabia during 1998-2010. The incidence and spectrum of ARMs, associated regional anomalies, and those with a positive family history of ARMs were identified. The 95% confidence interval and Chi square trend test were used to quantify the significance of variation in annual incidence.

RESULTS: One hundred eighty-eight cases of ARMs were detected from 189,145 live births with an incidence of approximately 1/1000 live births with a male-to-female ratio of 1.9:1. The incidence showed yearly stability (p=0.3509). The most common ARMs was perineal fistula (32.9%). There was a statistically significant gender difference (p=0.000). The most common in boys was rectourethral fistula (47.2%) and in girls was vestibular fistula (46.2%). Isolated non-familial ARMs was found in 106 (56.3%), isolated familial 9 (4.7%), and associated ARMs in 73 (38.8%) cases. In terms of associated anomalies, genitourinary (34%), and cardiovascular (19.2%) systems reported a high incidence.

CONCLUSION: The incidence of ARMs in Madinah Kingdom of Saudi Arabia, is higher than the reported data. Isolated ARMs was more common than the associated category, and the familial one was rarely reported.