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Warning-sign checks

Imperforate anus: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Go to an emergency department or call emergency services if a baby or child has:

    • Green vomit
    • Rapidly increasing abdominal swelling
    • Severe breathing difficulty, unusual sleepiness, or poor responsiveness
    • Repeated vomiting with inability to pass stool
    • Severe abdominal pain or signs of being very unwell
    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    A newborn with no visible anal opening, no passage of meconium, or stool coming from the urinary or genital area needs urgent medical assessment the same day.

    Do not insert a thermometer, suppository, or enema into an absent or abnormal opening.

    After surgery, seek urgent advice for fever with worsening wound redness, pus, heavy bleeding, persistent vomiting, marked abdominal swelling, or no stool output when stool would normally be expected.

    A dark, pale, or suddenly swollen stoma also needs urgent assessment.

    Urinary pain, frequent urinary infections, new leakage, or difficulty emptying the bladder should also be discussed promptly with the specialist team.

  3. 3

    Does any of this apply?

    Book an appointment

    Routine follow-up is appropriate for constipation, occasional soiling, skin irritation, concerns about toilet training, or a bowel programme that is becoming less effective.

Every sign above is quoted from the sofidex article on Imperforate anus. If you are not sure, err upward — it is always reasonable to be checked.