Chronic Constipation due to Undiagnosed Imperforate Anus with Rectovestibular Fistula in an 18 Month Old Female

An imperforate anus is usually diagnosed at birth or shortly thereafter with physical examination being the cornerstone of diagnosis and guiding further management [1]. Despite routine postpartum physical examination, one in five neonates born with imperforate anus has delayed diagnosis [2]. Such a delay in diagnosis may complicate the surgical repair and may contribute to both functional and psychological problems for the patient and family. Constipation is one of the leading and most common symptoms of presentation [2]. In girls, due to a higher frequency of low anorectal malformation, lesions likely tend to be missed in neonates [3]. We describe an unusual case of an 18 month old female with chronic constipation due to delayed diagnosed of the imperforate anus with recto vestibular fistula in the absence of associated syndromes. Even though this condition in common, there have only been a few cases of the imperforate anus with enter vestibular fistula in the literature, presenting at this age in developed countries.