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Imperforate Anus

Imperforate Anus. Maria Ellaine Grace K. Uy, MD. Pertinent Data: Imperforate Anus. PBR Delivered via Scheduled Repeat Cesarean Section 33 year old G2P2 (2002) AOG: 38 1/7 weeks MT: 38 AGA Apgar Score: 9,9. Anthropometrics: BW= 3350 grams BL= 52 cm HC= 34 1/2 cm CC= 34 cm AC= 29 cm.

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Imperforate Anus

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  1. Imperforate Anus • Maria Ellaine Grace K. Uy, MD

  2. Pertinent Data: Imperforate Anus • PBR • Delivered via Scheduled Repeat Cesarean Section • 33 year old G2P2 (2002) • AOG: 38 1/7 weeks • MT: 38 AGA • Apgar Score: 9,9 • Anthropometrics: • BW= 3350 grams • BL= 52 cm • HC= 34 1/2 cm • CC= 34 cm • AC= 29 cm

  3. Pertinent History: Imperforate Anus • Maternal History: 3rd Trimester, Cough and Colds, no medications given • Past Medical History: Scoliosis s/p Spine surgery (1993) • Family History: Diabetes, Hypertension • OB History: • G1- 2009- PCS for Arrest of descent- LFT- Male- TMC- No FMC • G2: Present Pregnancy • Personal Social: Post-graduate, Works as a market researcher, no vices

  4. Physical Examination: Imperforate Anus • Had good cry and activity • Clear amniotic fluid • Flat and open fontanelles • Good air entry, no retractions • Regular cardiac rhythm, HR at 150 bpm • Soft Abdomen • Grossly male genitalia • Imperforate Anus • Full pulses

  5. Diagnosis: Imperforate Anus • Term Baby Boy • t/c Imperforate Anus

  6. PLANS: • Transfer to Level III care • Maintain on NPO • Referral to Surgery

  7. Course in the NICU: Imperforate Anus

  8. Course in the NICU: Imperforate Anus

  9. Course in the NICU: Imperforate Anus

  10. Course in the NICU: Imperforate Anus

  11. Course in the NICU: Imperforate Anus

  12. Imperforate Anus • Absence of an anal opening • Occurs in 1 in 5000 births • - May have other associated problems: VACTERL

  13. Orphanet J Rare Dis. 2011; 6: 56. Published online 2011 August 16. doi: 10.1186/1750-1172-6-56

  14. If the air column is more than 1 cm from the perineum, a colostomy is indicated. Cross table lateral prone Xray

  15. The presence of meconium at the perineum, a bucket-handle malformation (ie, a prominent skin tag located at the anal dimple, below which an instrument can be passed), and an anal membrane (through which meconium is visible). A flat bottom or flat perineum, as evidenced by the lack of a midline gluteal fold and the absence of an anal dimple, indicates that the patient has poor muscles in the perineum. Anoplasty Colostomy

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