Anal Stenosis

Key Features

• Usually presents in the newborn period

• Anal aperture may be very small and filled with a dot of meconium

• Occurs in about 3 of 10,000 live births, with slightly more males affected

Clinical Findings

• Defecation is difficult

• Ribbon-like stools

• Blood and mucus per rectum

• Fecal impaction

• Abdominal distention

Diagnosis

• May not be apparent at birth because the anus looks normal

• Rectal bleeding in a straining infant often leads to a rectal examination, which reveals a tight ring in the anal canal

Treatment

• Dilation of the anal ring is usually curative but may have to be repeated daily for several weeks