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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


  • 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


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

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