Eight hundred and eighty-six cases with gastrointestinal anomaly were devided into eleven categories and analysed from the teratological viewpoints. They are esophageal atresia, intestinal atresia and stenosis, midgut malrotation, Hirschsprung's disease, imperforate anus, hypertrophic pyloric stenosis, neonatal gastric rupture, diaphragmatic hernia, abdominal wall anomalies (omphalocele, gastroschisis, prune belly and exstrophic cloaca), biliary atresia and choledochal cyst. There were high rate of low birth weight in esophageal atresia, abdominal wall anomaly and imperforate anus. These three anomalie also frequently combined with malformation of the other system including vertebra and limbs. Down's syndrome frequently combined with duodenal atresia (in 29%), Hirschsprung's disease, imperforate anus and diaphragmatic hernia of special type (Morgagni's hernia and hiatal hernia) but rarely combined with inguinal hernia in our series. We had three cases of esophageal atresia occurred in trisomy-18, on which a radical operation was not performed. Hirschsprung's disease and hypertrophic pyloric stenosis had large birth weight in average and had low incidence of combined anomaly including vertebra and limbs, contrary to the fact that the two are known as hereditary disease. Among 48 esophageal atresias and 250 anorectal malformations we have encountered 7 cases which have the both. In the seven cases three belonged to the complete form of VATER association, which were succumbed in all and were described in the details. The other four were VATE in one, ATER in one and ATE in two. Special attention should be paid on the sacral deformity in the baby with imperforate anus. One case of anal stenosis was treated by bougie but constipation was persisted. Anterior sacral meningocele (S-2) was diagnosed by digital examination and X-CT at eight months of age. A successful resection of the presacral meningocele was performed with complete recovery. Two cases with imperforate anus of high type had severe deformity of the sacrum accompanied with urinary incontinence. A radical pull through operation was carried out on the two cases with excellent result in regard to the bowel habits.
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