Virginia Via Research Day Book 2026

Medical Student Research Case Reports

37 A PRETERM NEONATE WITH VACTERL ASSOCIATION PRESENTING WITH VERTEBRAL, CARDIAC, RENAL, AND ANORECTAL ANOMALIES

Zita Venetianer, OMS-II; Edina Veszelovszky, MD Corresponding author: zvenetianer@vcom.edu

Adventist HealthCare Shady Grove Medical Center VACTERL association is a group of congenital anomalies involving vertebral defects, anal atresia, cardiac malformations, tracheoesophageal fistula/ esophageal atresia, renal anomalies, and limb abnormalities. Diagnosis typically requires at least three component features. While the incidence is low, early recognition in the neonatal period - especially in preterm infants - is critical for proper management. We present a case of a 32+1 week female neonate who was delivered via cesarean section for severe preeclampsia and breech presentation was found to have

multiple congenital anomalies at birth. The neonate was admitted to the NICU due to prematurity. After delivery, physical examination identified an imperforate anus with a fistula opening between the anal area and the vagina, and a two-vessel umbilical cord. Further workup at the NICU revealed further congenital anomalies, such as 13 ribs, cardiomegaly, two atrial septal defects, a patent ductus arteriosus, left renal genesis, small cysts in the right kidney, a low-lying conus medullaris at L3, thickened filum terminale, and a 6-mm filar cyst. No tracheoesophageal or limb anomalies were present.

This case represents a rare presentation of VACTERL association in a premature neonate and raises concern for Currarino syndrome given the coexistence of an anorectal malformation, sacrococcygeal abnormality, and presacral mass. Multidisciplinary involvement from neonatology, pediatric surgery, cardiology, nephrology, and urology facilitated comprehensive evaluation and early surgical planning. This report underscores the importance of systematic assessment of preterm infants with multiple congenital anomalies to guide timely diagnosis and management.

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