Is the perianal fistula a variation of anal duplication? Case reports and review

Abstract

Anorectal malformations are birth defects which include a wide range of diseases. With this defect, the anus and rectum don't develop properly. They can involve both genders. The involved organs in such malformations are anus, rectum, urinary and genital systems. The defects vary from very easy to very difficult curable. The incidence of these birth defects is about 1 in 5000 live births.On the other hand, perianal fistula and abscess formation are common perianal disease in children. The symptoms of perianal fistula are: secretion in the perianal area, pruritus and bleeding.Among alimentary tract duplications, anal canal duplication is the rarest and the more distal one, which has been defined as duplication along the posterior side of the anal canal, with a perineal orifice located behind the anus at 6 o'clock position and its physical aspect is duplicated anus.In this study, three cases were reported with anal duplication presenting a condition similar to perianal fistula.Reviewing these cases guide us to a new horizon that some fistulas or abscess formation in early age or in infancy might be a complication of underlying anal duplication. The proposed management for perianal fistula is fistulectomy. Keywords: Perianal fistula, Anal duplication