Congenital abnormalities of the anorectal region occur with an incidence of 1 in 4000 to 1 in 5000 live births.37-39 A very small minority may be familial with the majority being isolated findings or part of a congenital syndrome such as the VACTERL syndrome. There are a number of different types of anorectal anomalies resulting from the complex embryological development of the anorectal region involving differentiation of the cloaca. The Wingspread classification40 divides them into high, intermediate or low based on the relationship of the terminal bowel or any fistula arising from the bowel to the pelvic diaphragm. Precise definition of the abnormal anatomy is of paramount importance when planning corrective surgical treatment.
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