Phanuel H., 1

Phanuel is a 4-month-old infant, the first child of a very young and unemployed mother. He lives with his mother in the home of a relative, as they have very limited financial support. His father is absent, and the young mother depends largely on the kindness of her elderly aunt to meet their daily needs. His condition was first noticed about eight days after birth when the mother’s aunt observed that the child had no anal opening and was passing stool through the vaginal opening. This caused great anxiety for the family. They initially sought care at Barau Dikko Teaching Hospital and were later referred to the 44 Nigerian Army Reference Hospital. However, due to inability to afford the required investigations, they returned home without receiving definitive treatment. After several months without improvement, the child was identified during a Helpster Charity outreach at their church and was subsequently admitted into the program for proper medical evaluation and treatment.

Habila Phanuel, a 1-year-old girl, was managed for anorectal malformation with vestibular fistula after presenting with stool passing through the vagina. A fistulogram and other pre-op investigations including FBC, U/E/Cr, and GXM for 1 unit of blood confirmed the diagnosis and prepared her for surgery. She had a posterior sagittal anorectoplasty under general anesthesia on 21/6/2026 which was well tolerated, and post-operatively she received 150mls of blood transfusion, IV fluids, IV ceftriaxone, flagyl, and IV paracetamol. Her recovery was significant with good wound healing, and she was discharged on 2/7/2026 on oral medications. She is now passing stool optimally per rectum with no complaints, and continues twice weekly anal dilation to prevent stricture while on follow-up.

The infant has an anorectal malformation requiring surgical reconstruction to establish a normal anal opening and bowel passage. He is presently stable and being prepared for definitive corrective surgery. Complications of anorectal malformations include immediate risks like intestinal obstruction and surgical infections, as well as lifelong challenges such as chronic constipation or fecal incontinence. Patients may also face secondary issues like urinary tract infections, anal narrowing (stenosis), and significant psychosocial stress due to long-term bowel management needs. Following timely repair and proper follow-up, he is expected to achieve good bowel control and normal growth. The overall prognosis is favorable.