atresia ani by darmawati

7/23/2019 Atresia Ani by Darmawati

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Patient Identity

• Name : By Darmawati• Sex : Boy• Age : 1 days old• Address : Pango Raya, Kec. Ulee Kareng

Kota Banda Ace• Pone : !"#$%!!!"&!!• '( : 1 !# ") &#• Body *eigt : $1!! gr

• +ime Admission : 1.!$ P(



Chief Complaint

•Born without anal

Present illness history:

• Patient consult from pediatric division with a

chief complaint born without anal. helped by

a doctor . History of antenatal care (+) withmidwife. There was no history of feces come

out with urine. History of vomit (-)



Physical examination

Vital i!n

• "eneral #ppearance $ !ood

• uc%in! &efle' $ (+)• "raspin! &efle' $ (+)

• ryin! $ (+)

• Pulse $ * beat , min

• &espiratory rates $ breath ,min

• Body temperature $ */ o

•



-ocalie state : At a/dominal region

•0nsection : Distention 2334 , symmetrical ,Bowel

'onto5r 234 6ieremis s5ra5/ic234• A5sc5ltation : Bowel so5nd 274•Palation : soeel 274•Perc5sion : +ymani, li8er d5llness 274

At anorectal region• 0nsection : Anal 234 ,B5c9et andle 234, anal dimle

274, erineal ist5la 274,

mediana rae 274



Diagnose:• Anal imerorate wit erineal ist5la

2mediana rae4



Management• Sto oral inta9e

• 0;<D R- $!!cc=) o5r 1,# cc=o5rs• 'etriaxone 1#! mg• >?+ clear • Urinary 'ateter



Time Volume (cc)

1#.!! cc1%.!! $ cc

1@.!! $ cc

1".!! # cc

• 'ateter 5rine # cc=o5rs

• -a/oratory examination• Radiology examination



Laboratory examination• 6emoglo/in : 1",$ gr=dl

• *ite Blood 'o5nt : 1&.!!!=5l• Platelets : @.!!!=5l• 6ematocrit : #•

B+='+ : @=• Sodi5m : 1$@ mmol=-• Potassi5m : #.% mmol=-



Radiology examination:

Baby Gram :

• 0ilatation of Bowel



Diagnose• -ow le8el anal imerorate wit erineal

ist5la 20'D 1! '( C).4

Planning:

•'ons5lt to ediatric s5rgery di8ision

(inimal PSA



Intra Operative• 0dentiication anal dimle area

• <o5nd mediana rae ist5la 2erineal ist5la4• Perormed incision 1 cm at mediana rae• 0ncision deeened 5ntil o5nd rect5m• Rect5m st5m oened, erormed rectoanal

anastomosis to neo anal



Post operation diagnose:• -ow le8el anal imerorate wit erineal

ist5la 20'D 1! '( C).4



ollo! "p

Date S O A P=@=!1#P>D $

3 6R : 1)"/eats=min5teRR : $& x=min5te+ : $%,# '

a=r A/domen:0: simetrical,distension 234 , stomarod5ction 274,8ital,eces 274

A: /owel so5nd 274P. li8er d5llness 274

-ow le8elanalimeroratewit erineal

ist5la 20'D1! '(C).4

Breasteeding3 0;<D ):1$!!cc=)

o5rs3 'etriaxonein.1#!mg=1r3 (etamiol

sodi5m in.#! mg =" r

atresia ani by darmawati

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