C Anorectal Malformation Jadi

8/18/2019 C Anorectal Malformation Jadi

1/13

By C/F/2do


2/13

Chief Complain : absence of anus

It has been happened since born, the babywas born by midwife with normal delivery,BBW:28 !r, aterm, she is the "rst child, nohistory of con!enital anomaly in the family#$istory of %&C by midwife 2 times#'istension ()* since born, +omitin! (*,-icturition ()* &ormal#


3/13

General Examination

• .ensorium : %lert

•

$ : 028 1 / min• emp : 34,5 6 C

• : 77 1 / min


4/13

Physical Examination

$ead : Con palp inf anemic (*,sclera icteric(*

hora1 I : simetris

9 : sonor

% : +esicular both hemithora1


5/13

%bdomen :

I : .imetris, distension ()*9 : supple, defans muscular (*,tenderness (*

9 : hypertymphani% : peristaltic ()* increased

%nus : (*, "stula (*

enitalia : Female, "stula (*


6/13

Laboratory Finding

$b / $t / ; / 9lt : 07#0/ 70#3 / 02#43 / / Cl : 03< /


7/13

adiolo!y Findin!s

Baby !ram :

Cor, diaphra!m was !ood

9ulmo : bronchovascular shadow was normal

'istributiion of air in bowel was normal

Bones and soft tissues were !ood

>nee chest position : here is distancebetween sAin marAer and distribution of airin rectum was 0 cm


8/13

• Working Diagnosis : %norectal -alformation WithoutFistule $i!h ype

Management in Emergency Room• Installation of I+ line 28cc/27hours

• Installation of

• Installation of =rinary Catheter, Came out clear yellow 3cc

•

In# %ntibiotics• 9reparation for .i!moidostomy


9/13

In peratin! heatre

• 9atient in .upine 9osition , Caudal anastesi,aseptic, antiseptic and drappin! procedure

•

% contra mcburney Insicion was made , cutissubcutis fascia,peritoneum was opened, cameout serous Duid 0 cc# Identi"cation of .i!moid

• 9erformed .purs .utured in 8 places and

.i!moidostomy was performed• Bleedin! control

• peration was "nished


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C Anorectal Malformation Jadi