Congenital rectal stenosis diagnosed using an anoscope to detect a mucosal web with an orifice: a case report

Rectal stenosis (RS) is a rare variant of anorectal malformation, characterized by a normally positioned anus with well-developed functional sphincters. An inaccurate diagnosis of RS may affect the choice of surgical procedure. We present a case of RS diagnosed via anoscopy and treated with transanal surgery. A 2-day-old male infant presented with failure to pass meconium and abdominal distension. Although the anus was normally positioned, catheter insertion was obstructed at slightly more than 1 cm. Anoscopy revealed a rectal web with an orifice, enabling catheter decompression. Web resection and strictureplasty were performed on Day 5. The postoperative course was favorable, and bougie dilation was discontinued 1 year postoperatively. Anoscopy is easily performed at the initial visit and facilitates the detection of a web with an orifice, even when it is barely visible externally. This approach enables safe catheter insertion and appropriate surgical planning.