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ARM
- 1. ANORECTAL MALFORMATION Approach Of A Pediatrician To A Case Of Newborn With ANORECTAL MALFORMATION Speakers -Dr.Sushmita Ghosh Moderator-Dr.M.K.Mohanty(Paed.Surgeon) Jawaharlal Nehru Hospital & Research Centre Bhilai Steel Plant Hospital dnbpaediatrics.blogspot.in
- 2. INTRODUCTION Anorectal malformation- Complex disorder ranging from cloaca (most severe) to perineal fistula. Invertogram- in 1930 Upto 1948 Surgical correction-Rhodes Since 1982- PSARP by Alberto Pena dnbpaediatrics.blogspot.in
- 3. ROLE OF PEDIATRICIAN Intramural Extramural (delivery-own hosp.) *diagnosis (outside delivery) *initial stabilization *diagnosed outside *referral to paed.surgeon *stabilization *treatment of sepsis,if any dnbpaediatrics.blogspot.in
- 4. BABY DELIVERED THOROUGH CLINICAL EXAMINATION ANORECTAL MALFORMATION(ARM) MALE FEMALE dnbpaediatrics.blogspot.in
- 5. NEWBORN WITH ARM (MALE) PERINEAL INSPECTION AND URINALYSIS CLINICAL EVIDENCE(80-90%) QUESTIONABLE( 10-20%) PERINEAL FISTULA “FLAT BOTTOM” INVERTOGRAM “BUCKET HANDLE” MECONURIA MIDLINE RAPHE FISTULA AIR IN BLADDER ANAL STENOSIS (XRay Finding) ANAL MEMBRANE >1 CM BOWEL- <1 CM BOWEL- SKIN DISTANCE SKIN DISTANCE dnbpaediatrics.blogspot.in
- 8. NEWBORN WITH ARM (FEMALE) PERINEAL INSPECTION FISTULA(APPROX.90%) NO FISTULA(APPROX.10%) SINGLE OPENING TWO OPENINGs THREE OPENINGs CLOACA VAGINAL CUTANEOUS OR (PERINEAL) INVERTOGRAM VESTIBULAR >1 CM BOWEL- <1 CM BOWEL- SKIN DISTANCE SKIN DIST. dnbpaediatrics.blogspot.in
- 11. VESTIBULAR FISTULA WITH IMPERFORATE HYMEN dnbpaediatrics.blogspot.in
- 12. VESTIBULAR FISTULA dnbpaediatrics.blogspot.in
- 14. INCIDENCE WORLDWIDE 1:5,000 LIVE BIRTHS GENETIC PREDISPOSITION IN CERTAIN FAMILIES ASSOCIATION WITH CERTAIN SYNDROMES- VACTERL,VATER,DOWN’S SYNDROME SLIGHT MALE PREPONDERANCE IN FEMALES-RECTOVESTIBULAR FISTULA MOST COMMON IN MALES -RECTOURETHRAL FISTULA MOST COMMON dnbpaediatrics.blogspot.in
- 15. INITIAL MANAGEMENT RED RUBBER CATHETER INSERTION NBM & INTRAVENOUS FLUIDS FIRST LINE ANTIBIOTICS- CLOXACILLIN & AMIKACIN INJECTION VITAMIN K NASOGASTRIC DECOMPRESSION after 24 hrs dnbpaediatrics.blogspot.in
- 16. ASSOCIATED MALFORMATIONS (50-60%) UROGENITAL- URINARY-UNILATERAL AGENESIS OF KIDNEY -PUJ OBSTRUCTION -HYPOSPADIAS -VUR GENITAL- BICORNUATE UTERUS -UTERUS DIDELPHYS -VAGINAL SEPTUM -BLIND HEMIVAGINA -ATRESIA OF CERVIX -HYDROCOLPOS CARDIOVASCULAR- 1/3RD Pts -ASD,PDA most common -VSD,TOF dnbpaediatrics.blogspot.in
- 17. GASTROINTESTINAL-TRACHEOESOPHAGEAL ANOMALIES -DUODENAL OBSTRUCTION (ATRESIA/MALROTATION) SPINOVERTEBRA L -HEMIVERTEBRAE -SCOLIOSIS -HEMISACRUM -ABSENT SACRUM -BUTTERFLY VERTEBRAE - TETHERED CORD -SPINAL LIPOMAS -SYRINGOMYELIA -MYELOMENINGOCELE dnbpaediatrics.blogspot.in
- 18. INVESTIGATIONS INVERTOGRAM(10-20% CASES) -by Wangensteen and Rice(1930) PRONE CROSS TABLE LATERAL XRAY -by K.L.N Rao et al(1991) BABYGRAM ULTRASOUND ABDOMEN ECHOCARDIOGRAPHY dnbpaediatrics.blogspot.in
- 19. INVERTOGRAM DONE AFTER 16-18 HRS dnbpaediatrics.blogspot.in
- 21. AT BIRTH - GAS IN STOMACH 6-8 HRS - GAS REACHES ILEOCAECAL JUNCTION 12-18 HRS - GAS REACHES RECTUM dnbpaediatrics.blogspot.in
- 22. INVERTOGRAM -position dnbpaediatrics.blogspot.in
- 28. PRONE CROSS TABLE LATERAL XRAY-position dnbpaediatrics.blogspot.in
- 29. PRONE CROSS TABLE LATERAL XRAY dnbpaediatrics.blogspot.in
- 30. Visit and join dnbpaediatrics.blogspot.in Free blog for postgraduates in pediatrics