The signs of imperforate anus are usually obvious soon after birth. They include:

no anal opening

an anal opening in the wrong place, such as too close to the vagina

no stool in the first 24 to 48 hours of life

stool passing through the wrong place, such as the urethra, vagina, scrotum, or the base of the penis

a swollen abdomen

an abnormal connection, or fistula, between your baby’s rectum and their reproductive system or urinary tract

About half of all babies born with imperforate anus have additional abnormalities. Some of these may be:
kidney and urinary tract defects
abnormalities of the spine
windpipe, or tracheal, defects
esophageal defects
defects of the arms and legs
Down syndrome
Hirschsprung’s disease, which is a condition involving missing nerve cells of the large intestine
duodenal atresia, which is an improper development of the first part of the small bowel
congenital heart defects