EP07.69: Unveiling the unforeseen: antenatal diagnosis of high anorectal malformation masquerading as an intrabdominal mass"

High anorectal malformation is a rare congenital condition with varied clinical presentations. We present the case of a 27-year-old primigravida at 38 weeks and 6 days of gestation referred for evaluation of a fetus with a solid cystic abdominal mass. Ultrasound showed a distended rectosigmoid colon with a thickened colon wall and multiple large echogenic fecaliths. There was no ascites or visible peristalsis. Fetal MRI confirmed a high anorectal malformation causing large bowel obstruction, with a grossly dilated sigmoid and descending colon, suggesting a recto-vesical fistula. A healthy baby with ambiguous genitalia was delivered at 40 weeks and underwent colostomy at 48 hours of life. This case highlights the importance of considering high anorectal malformation in the differential diagnosis of solid cystic abdominal masses, especially with features like fecalith and distended bowel, for appropriate delivery planning and neonatal management. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.