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Perineal groove - A rare congenital anorectal malformation

Ana Raquel Claro¹, Inês Soares², Sofia Pires², Daniela Ramos²
¹Serviço de Pediatria, Hospital de Santa Maria – Centro Hospitalar Universitário de Lisboa Norte, EPE, Lisboa, Portugal, ²Serviço de Pediatria, Hospital de Vila Franca de Xira EPE, Vila Franca de Xira, Portugal

Address for Correspondence: Ana Raquel Claro - Serviço de Pediatria, Hospital de Santa Maria - Centro Hospitalar
Universitário de Lisboa Norte, EPE, Lisboa, Portugal
Email: ana_claro92@hotmail.com

Keywords : perineal groove, anorectal malformation, neonatology

Question :

A newborn term girl, daughter of healthy non-consanguineous parents, was delivered by a cesarean section after an unremarkable pregnancy.
At 24 hours of life, physical examination revealed an unclosed posterior vaginal commissure, which extended to the anterior edge of anal verge at 12 o'clock position in a wet-based erythematous non-keratinized sulcus and anteriorly placed anus (Figure 1 and 2). The remaining physical examination was normal and the patient was passing meconium without changes.
The diagnosis of a congenital complete perineal groove was established on the basis of clinical findings and the patient was discharged at 48 hours of life. At seven months of age, she spontaneously healed the sulcus without complications (Figure 3).

Figure 1.Posterior vaginal commissure not closed.

<b>Figure 1.</b>Posterior vaginal commissure not closed.

Figure 2. Up to the anterior surface of the anus in a sulcus with a moist base.

<b>Figure 2.</b> Up to the anterior surface of the anus in a sulcus with a moist base.

Figure 3. Healing of the perineal groove lesion at 7 months of age.

<b>Figure 3.</b> Healing of the perineal groove lesion at 7 months of age.

What is the perineal groove?

Discussion :

The perineal groove is a congenital anorectal malformation, more frequently described in female newborns and characterized by a painless, moist, mucous-lined sulcus located in the perineum's midline, from the fornix of the vagina to the anus.^1,2,3 The perineal groove pathogenesis remains unclear.^1,2,3 The diagnosis is made clinically and in most cases, the lesions are asymptomatic and resolve spontaneously within a year of presentation.^1,3
In most cases, the perineal groove isn't associated with other malformations. However, few studies reported the association with hypospadias, unspecified urinary tract abnormalities and anteriorly placed anus.^1,2,3 This condition is uncommon and is not known to many clinicians. It's important to be aware of this entity since it can be confused with other diagnoses such as contact dermatitis, trauma or sexual abuse^1,2,3, to provide appropriate counseling and avoid unnecessary interventions.

References :

AlAbidi GA, Hamidi S Al, Wahid FN. Perineal groove in a female newborn: Report of two cases. J Pediatr Surg Case Reports [Internet]. 2021;66:101794p. Available from: https://doi.org/10.1016/j.epsc.2021.101794
Harsono M, Pourcyrous M. Perineal Groove: A Rare Congenital Midline Defect of Perineum. Am J Perinatol Reports. 2015;06(01):e30-2p.
Cheng H, Wang Z, Zhao Q, Zhu H, Xu T. Perineal groove: Report of two cases and review of the literature. Front Pediatr. 2018;6(August):6-10p.

Correct Answers :

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Last Shown : Jul 2023

Perineal groove - A rare congenital anorectal malformation

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