C Anorectal Malformation Jadi
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Transcript of C Anorectal Malformation Jadi
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8/18/2019 C Anorectal Malformation Jadi
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By C/F/2do
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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#
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General Examination
• .ensorium : %lert
•
$ : 028 1 / min• emp : 34,5 6 C
• : 77 1 / min
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Physical Examination
$ead : Con palp inf anemic (*,sclera icteric(*
hora1 I : simetris
9 : sonor
% : +esicular both hemithora1
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%bdomen :
I : .imetris, distension ()*9 : supple, defans muscular (*,tenderness (*
9 : hypertymphani% : peristaltic ()* increased
%nus : (*, "stula (*
enitalia : Female, "stula (*
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Laboratory Finding
$b / $t / ; / 9lt : 07#0/ 70#3 / 02#43 / / Cl : 03< /
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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
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• 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
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In# %ntibiotics• 9reparation for .i!moidostomy
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In peratin! heatre
• 9atient in .upine 9osition , Caudal anastesi,aseptic, antiseptic and drappin! procedure
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% 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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