Some observations on anorectal malformations in Zimbabwe.

Forty-six cases of anorectal malformations (ARM) were seen over a period of 28 months in the elective paediatric surgical service of the two teaching hospitals in Harare, Zimbabwe, of whom 20 (43,5%) were males and 26 (56,5%) were females. Twenty-two (47,8%) of the cases had a 'high' anomaly while 21 (45m7/5) had a 'low' anomaly, and the remaining 3 cases (6,5%) had a 'cloaca' malformation. Twelve (26%) of the cases were shown to have major associated congenital anomalies affecting mainly the uro­ genital, musculo-skcletal or cardiovascular systems. About three-quarters of the cases were referrals from other hospitals. The apparently peculiar geographical distribution of ARM in Zimbabwe and some of the problems encountered in the management of these cases are presented and discussed. A plea is made for the rational and skilful management of this major and challenging paediatric surgical problem in Zimbabwe.