A meaningless finding for gastroenterologist : Ano-rectal malformation in adult

Ano-rectal malformations (ARM) are infrequent anomalies with estimated incidence between 1/3300- 1/5000 live birth (1). Diagnose of ARMs can be done in early childhood because of early symptoms or concomi- tant anomalies consisting of genitourinary, spinal, cardio- vascular, gastrointestinal, craniofacial systems (2-4). Late diagnosis of ARMs (after first 48 hours of birth) may result in spontaneous perforation of intestine. By this case, we present a late diagnosed type of ARM with chronic constipation. The women, aged 58 years old, had a normal physical examination, but the vestibular ectopic anus. The anus was observed inside the vestibular area, but separated from vagina by mucosal septum. Muscular structure were palpated backward of the anal orifice. Colonoscopy did not reveal any significant pathology. As seen in our case, the patients with isolated vestibu- lar ectopic anus may survive without any complication for life. Therefore, gastroenterologists should not be aware of adult onset ARMs.