A team consisting of Dr Bhavesh Doshi, Consultant Pediatric Surgeon, and Dr Nitu Mundhra, Neonatologist successfully treated a one-year-old infant with a rare congenital malformation called Ano Rectal Malformation, which means the baby has no anal opening. After birth, the infant underwent a series of five surgeries such as colostomy, anal reconstruction, and colostomy closure to address issues of Anorectal Malformation (ARM) and other issues like hypospadias and tongue tie. Despite these challenges, the baby is successfully reaching developmental milestones appropriate for his age

Mr. and Mrs. Salian from Mira Road welcomed their first child into the world. However, their happiness turned to shock when they were informed that the newborn had a congenital condition called anorectal malformation (ARM) which resulted in the absence of an anal opening. The baby had other problems like Hypospadias which means the penis was bent and the opening of the urinary hole was not at the place.  The baby was immediately admitted to the Neonatal Intensive Care Unit (NICU) at Wockhardt Hospitals, Mira Road, and initiated on parenteral nutrition since breastfeeding was not feasible.

Dr. Nitu Mundhra, Consultant Neonatologist and Lactation expert, Wockhardt Hospital, Mira Road said, “ARM (anorectal malformation) is rare, and often comes as a shock to parents as it may not be diagnosed in the antenatal usg scans. It’s a rare disease and one in lakh children are born with this defect. In the delivery room, all the babies are examined from head to toe to look for any abnormalities, especially when they have one abnormality”. So, like this baby had Anal Malformation in the delivery room we immediately looked for other abnormalities. He also had bent over the penis along with an abnormal position for urinary meatus (Hypospadias) and a tongue tie- a condition where the tongue is attached to the floor of the mouth, it is not possible to protrude the tongue which may lead to breastfeeding problem and speech difficulty. After appropriate counseling of the parents, the baby underwent multiple surgeries.

Dr Bhavesh Doshi, Pediatric Surgeon, Wockhardt Hospitals Mira Road said, “The complete treatment of anorectal malformation was done in 3 surgical steps. At birth, a colostomy was done. In this problem, we have to make a temporary opening (making a bypass passage for stool, so that the baby can be started on feed). At 2 months of age a 4-hour-long surgery Posterior sagittal Ano Rectoplasty (PSARP) was performed where the new Anus was created at the normal position. 2 months after the second surgery, the child underwent the final surgery for ARM, colostomy closure. During the surgery, the opening which was created in the abdominal wall is closed and the child now passes motions from the normal opening.”

Dr Bhavesh further added, “Finally, at one year of age, the child again had to undergo major surgery for correcting the bent-over of the penis and get the urinary opening to the normal position. After the 3 hours long surgery, the child passed urine from the normal position at the tip of the penis.”

Now the child is one year old and able to achieve all milestones as per his counterparts. The baby underwent 5 surgeries by 1 year of age. Explain the challenges faced by the team. Not treating him at the right time could have failed to thrive. Said Dr. Nitu Mundhra

“We are thankful to the Doctors for saving our baby and giving us a new way of life. My baby is doing well now and is at par with the other kids of the same age.” Thanks to all the doctors for supporting us.” concluded the couple Mr. and Mrs. Salian