Background: Anorectal malformations (ARM) are usually diagnosed at birth, although, some patients have presented in the hospital beyond the newborn period without recognition of the anomaly. Late presentation in adulthood has also been reported. We report a case of adult ARM whose mother was instructed not to present in the hospital until she was old enough.
Method: An adult female patient was evaluated and investigated preoperatively for high ARM with rectovestibular fistula. She had an initial colostomy which was followed by a primary posterior sagittal anorectoplasty (PSARP). Post-operatively, continent level was assessed using the Kelly continent score.
Results: She had good post-operative recovery with an episode of faecal soilage. The Kelly continent score was 3 which later improved to 5.
Conclusion: Although the sphincteric tone may be weak in the adult patient with ARM with reduced continent level at the initial stage, overall outcome of management of ARM with primary PSARP is good and comparable to outcome in children.