Anorectal malformation as a cause of recurring perineal abscesses – value of anorectal endosonography and magnetic resonance imaging: a case report

Abstract

Malformations of the rectum and urinary tract frequently coexist, and the prevalence of urogenital defects in patients with a rectal defect ranges from 20 to 54%. In most patients, anorectal malformations are diagnosed and treated surgically in early childhood. In this report, we present a case of a 52-year-old male with a history of urological operations in infancy due to a congenital urethral malformation and multiple recurrent episodes of perineal abscesses with urinary retention. Anorectal endosonography and magnetic resonance imaging revealed the presence of a large cystic lesion adjacent to the rectal wall which became smaller at the level of the puborectalis. The walls of the lesion had a layered structure identical to the wall of the rectum. In addition, the examinations showed hypotrophy of the left lobe of the prostate and lack of left semnal vesicles. Thus, the lesion was diagnosed as duplication of the rectum or rectal diverticulum. Surgery was performed by an interdisciplinary team of colorectal surgeons and urologist. The lesion was removed laparoscopically. The pathological report revealed that the cystic wall was typical of the intestinal wall, consistent with a diagnosis of rectal duplication.

Delayed presentation of congenital rectal stenosis associated with Down's syndrome and hypothyroidism: Case report

“…The reasons for the delayed presentations in these cases were reported as family negligence, family problem, social taboo, low‐economic condition, low level of education, not seeking medical advice, awareness about physical problems only during the time of decision for marriage, and lack of access to medical care. 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 …”

“…The reasons for the delayed presentations in these cases were reported as family negligence, family problem, social taboo, loweconomic condition, low level of education, not seeking medical advice, awareness about physical problems only during the time of decision for marriage, and lack of access to medical care. [9][10][11][12][13][14][15][16] Evidences suggest that low socioeconomic status influences one's health and morbidity. 17 It affects clinical decision making and healthcare delivery as physicians may delay diagnostic testing, prescribe more generic medications, and avoid referral to specialty care for their patients.…”