seminar presentation on anorectal malformation of pediatrics nursing

1. SEMINAR
PRESENTATION ON
ANORECTAL
MALFORMATION
D I K S H A
S I N G H

2. INTRODUCTION
 ANO means the anus and RECTAL means rectum.
 ANORECTAL MALFORMATION are birth defect or
problems that happen as an unborn baby is
developing during pregnancy with this defect the
anus and rectum don’t develop properly they are
lower part of the digestive tract.

3. DEFINITION
 ANORECTAL MALFORMATION ARE
DEVELOPMENTAL DEFORMATIES OF LOWER
END OF THE ALIMENTARY TRACT.

4. CAUSES
 URINARY TRACT ABNORMALIIES
 ABNORMALITIES OF THE SPINE
 DIGESTIVE SYSTEM ABNORMALITIES
 VACTERAL(a syndrome in which there are vertebral
, anal, cardiac, tracheal , renal and limb
abnormalities)

5. TYPES
 Anal stenosis
 Anal membrane atresia
 Rectal atresia
 Imperforate anus

6. PATHOPHYSIOLOGY
 GENITOURINARY TRACT ORIGINATES FROM
THE EMBRYONIC STRUCTURE CALLED CLOACA
 BYY THE WORK OF GESTATION MEMBRANE
SEPARATES THE RECTUM FROM ANUS
 IF THE MEMBRANE THAT SEPARATES ANUS IS
NOT ABSORED
 UNION OF ANUS AND RECTUM DOES NOT
OCCUR
 RESULTNG IN ANORECTAL MALFORMATION

7. SIGN AND SYMPTOMS
 LACK OF STOOL
 STOOL COMING FROM THE VAGINA
 URINE COMING FROM THE ANUS
 TROUBLE HAVING A BOWEL MOVEMENT OR
CONSTIPATION

8. DIAGNOSTIC EVALAUTION
 DETECTION OF IMPERFORATED ANUS
 NO ANAL OPENING
 GLOVED FINGER OR THERMOMETER CANNOT
BE INSTERED INTO INFANT RECTUM
 NO HISTROY OF PASSAGE OF MECONIUM
 PRESENCE OF DISTENSION
 PRESENCE OF MECONIUM IN URINE,
INDICATING RECTOVAGINAL FISTULA

9. INVESTIGATION
INVERTROGRAM
ABDOMINAL ULTRASOUND
INTRAVENOUS PYELOGRAM

10. MANAGEMENT
 DURING THE FIRST 24 HOURS THE NEONATES
SHOULD-
 PERINEAL EXAMINATION
 PROVIDE NOTHING ORALLY
 PROVIDE IV FLUID
 ANTIBIOTICS
 NGT TO EXCLUDE ESOPHAGEAL ATRESIA
 ECHOCARDIOGRAM TO EXCLUDE MALFORMATION
0F CARDIAC
 RADIOGRAPH
 ULTRASOUND

11. SURIGCAL MANAGEMENT
 ANOPLASTY
 PSARP( POSTERIOR SAGITTAL
ANORECTOPLASTY) OR PENA’S PROCEDURE

12. NURSING MANAGEMENT
 PRE-OPERATIVE NURSING CARE-
 AFTER BIRTH AS SOON AS THE ANORMALY IS
NOTICED, ORAL FEEDING SHOULD BE STOPPED
 IV FLUID ARE STARTED TO MEET NUTRITIONAL
REQUIREMENTS
 ABDOMINAL GIRTH SHOULD BE MEASURED
 GASTRIC COMPRESSION SHOULD BE DONE BY
NASOGATRIC ASPIRATION
 MONITOR VITAL SIGNS PREPARE THE FAMILY
PSYCHOLOGICALLY FOR INFANT SURGERY

13. POST OPERATIVE CARE-
 INTRAVENOUS FEEDING TILL THE WOUND HEALS
 PREVENTION OF CONSTIPATION BY EXCLUSIVE
BREASTFEEDING AND PROPER WEANING WITH STOOL
SOFTENER
 BOWEL HABIT TRAINING
 PROVIDE ENEMA
 DON’T USE DIAPER IN CASES OF ANOPLASTY
 COLOSTOMY CARE BY CHANING TE COLLECTION
DEVICE
 FAMILY SUPPORT , DISCHARGE PLANNING AND HOME
CARE