Spontaneous perforation of the colon and rectum complicating anorectal malformations in neonates

Colorectal perforation is associated with considerable morbidity and mortality in neonates with ARM. Radiographs rather than clinical examination should be relied on for diagnosis of bowel perforation in ARM. Treatment options are chosen according to the subtype of perforation. Because most perforations occurred more than 24 hours after birth, early referral and surgical decompression of the colon may avoid this complication.