Colorectal Quiz Episode 13: Newborn ARM Part 2

Congenital perineal groove usually epithelializes on its own by age two

Perineal groove can be misdiagnosed as contact dermatitis, trauma, or sexual abuse

Three qualities to assess in anal location are: anal size, location (whether surrounded by sphincter), and perineal body size

Urogenital sinus plus normal anus is an endocrine problem, but no anus and urogenital sinus is a cloaca

Use Hagar dilators starting low and working up for accurate anal size measurement; do not use fingers because every surgeon has different size glove

Female ARM exam requires determining number of perineal orifices: three orifices means perineal or vestibular fistula; two orifices raises question of fistula presence, vaginal atresia, or rectovaginal fistula; one orifice is cloaca