Anorectal Malformation

	Plain X-ray shows air in the proximal blind pouch indicating Esophageal atresia which is commonly associated with anorectal malformation. A condition that must be excluded before invertogram to avoid reflux of gastric contents through the T-E fistula
	Invertogram demonstrated air in the distal blind rectal pouch, a radiopaque object is placed over the perineum to outline the skin level which is very near to the rectal pouch, low type anomaly can be diagnosed.
	Invertogram demonstrated air in the distal blind rectal pouch, a radiopaque object is placed over the perineum to outline the skin level which is very near to the rectal pouch, low type anomaly can be diagnosed.
	Invertogram, lateral view , showed that the distal pouch is not far away from the perineum and also showed the air in the fistula tract in low type malformation
	Contrast study demonstrated the fistula tract between the distal rectal pouch and urethra in rectourethral fistula (high type).
	Distal rectal pouch, urethra, bladder and rectourethral fistula demonstrated by contrast study indicate the high type anomaly
	Sacral agenesis or absence of sacrum and coccyx in anorectal malformation. Usually associated with poor neurological control of sphincter
	Anoplasty is the operation for low type anomaly, approached through the perineum. The distal rectal pouch is noted
	Thick meconium is observed while the distal pouch is open
	Colostomy is the initial procedure of choice in high type malformation. Gastrostomy is also performed in a case with associated esophageal atresia