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Association of anorectal malformation with duplicated colon, sacral meningomyelocele and scrotal anomalies

A 3-day-old male baby presented with anorectal agenesis, sacral meningomyelocele (MMC), bifurcated scrotal raphae, abdominal distension and septicaemia. X-ray in the prone position cross table view showed high anorectal malformation. On exploration for colostomy, an 8 cm terminal (sigmoid and descending colon) colonic tubular duplication was found. Both the colonic segments were communicating proximally to each other and distally with urinary bladder, along with complete anorectal agenesis. The excision and repair of the colovesical fistula were done. The colonic segment communicating proximally to the normal colon was exteriorised by window colostomy. The high-resolution ultrasonography of the scrotum revealed two well-developed testis. The bifurcated scrotal raphae and sacral MMC were left to be treated in the future. Unfortunately, the baby died in the immediate postoperative period due to ongoing sepsis.