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MALFORMASI ANOREKTAL (MAR)

OLEH:

DR. DION FAISAL

PEMBIMBING:

DR. ARIANDI S SP.B SP.BA

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KASUS: BAYI, LAKI-LAKI USIA 2 HARI

LAHIR TANPA ANUS

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SEJARAH

Paulu A!"#$!%a (A&a' !-): a$u#*+!a%a. /$"!0$#!+#$%.

S1ul%!% (334): '#la%a# %!$# a$#

5! (33): #$1## 6 '#la%a#,+7#$1%! *u1l! 1a!

B!ll (8): #$1## *#'l#$! +!#$!al

Du&# (89): l%*# #$"u#$al. A*ua% (89): +%+la%# +!#$!al

D#!;!$&a17 (823): %a$+## a$u

L!

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57aa#"$a1 (83): +&! %7u"7 a %*a  '#!# +!#$!al

L!##$ (82), M1L!' (884), a$' Ha'a(88=): I$1## a&'*#$al

>a$"!$%!!$ a$' R#1! (?94): #*a"#$"(#$

G!"!$ (2444): a$+la%# la+a+#.

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INSIDEN

0=444 444 !la7#a$ 7#'u+, !'##% l! !#$" +a'ala#-la#.

D!! +al#$" !#$": MAR '!$"a$ /%ula !%u!%7a(la#-la#) 6 /%ula !%

A$u #*+!a%a %a$+a /%ula (), %!a#% '!$"a$ DC$

@$'*!.

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DEFINISI 6 KLASIFIKASI

Defnisi: M!$""a*&aa$ +!%u* lua ua%u+!$@a#% ('#!a!), 'a+a% %!a'# +a'a la#-la# 'a$+!!*+ua$, *!l#&a%a$ a$u '#%al 'a$ !%u* !%a%a%u u#$a#u 'a$ "!$#%al#a.

Klasifkasi:

Du"la S%!+7!$ (?=) P!$a (?84)

>#$"+!a' (?8=)

RSUD D. S!%* Sua&a@a :

KLASIFIKASI PURWADIL!

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STEPHEN 6 SMITH(?39)

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PENA (?84)

L!

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>INGSPREAD (?8=)

>a7lu AK. ??. MANAGEMENT OF 5ONGENITAL ANORE5TALMALFORMATIONS. Ju$al I$'#a$ P!'#a%#1. OI.UME 92

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KLASIFIKASI & TATALAKSANA

MALFORMASI ANOREKTAL PURWADI

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ETIOLOGI

R!*a#$ u$1l!a

L#!l@ *ul%#a1%#al K*+$!$ "!$!%#

Au%*al '*#$a$

I$#'!$ MAR *!$#$"a% +a'a %#*@ 2 (DC$@$'*!), ? +a#!$ %#*# 2 'a$ MAR *!*#l##atresia ani tanpa fstula

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HIGH DEFORMITIES(SUPRA LEATOR)

MALE S FEMALE

A$!1%al A"!$!#

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HIGH DEFORMITIES(SUPRA LEATOR)

MALE S FEMALE

R!1%al A%!#a

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INTERMEDIETEDEFORMITIES

MALE S FEMALE

A$al A"!$!#

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INTERMEDIETEDEFORMITIES

MALE S FEMALE

A$!1%al S%!$#

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LO> DEFORMITIES(TRANS LEATOR)

MALE S FEMALE

A% N*al A$al S#%!

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LO> DEFORMITIES(TRANS LEATOR)

MALE S FEMALE

A% P!#$!al S#%!

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LO> DEFORMITIES(TRANS LEATOR)

FEMALE

A% ul

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MIS5ALLENOUS DEFORMITIESMALE S FEMALE

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BU5KET HANDLE DEFORMITY

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5LOA5A

K##: P!#%!$% 1la1a +!#$!u*. Ka$a$ &aCa7: H#'1l+

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DIAGNOSIS

PEMERIKSAAN FISIK T7! urs!r" !a*#$a%#$ %7! +!#$!u*.Prenatal:

USG: a$u $*al (1#1ula #* 7@+!17"!$#1#%@ C#%7 a 1!$%al l#$!a

!17"!$#1 %#+!). D#la%a# l$,l#"7#'a*$#$ 6 7#"7l@ '#%!$'!'

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 T7! %a$'u1! # *

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Ne!natal (+!#$!al !a*#$a%#$):

P!!$1! a&!$1! %7! a$u P!!$1!

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Flat perineu.) a1#a%!' C#%7 a7#"7 a$*al@

Me!niu. at t+e uret+ral.eatus, '!*$%a%#$" +!!$1!

a /%ula

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 TUJUAN ASSESSMENT A>AL

M!$!$%ua$ l!

M!$'u*!$%a#a$ a$*al# la#$ @a$" *!*+!$"au7#

u

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ASSO5IATED ANOMALIES

Hal 1a! 7a

Ga%#$%!%#$al a$*al#! (-4)

A5TERL (=-?) a$*al#!.

Endo M et al. Analysis of 1,992 patients with anorectal malformations over the past two decades

in Japan. J Pediatr Sur. 1999!"#$#"%

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PRONE, 5ROSS-TABLE LATERAL

RADIOGRAPH

Pu&111@"!al (P5) l#$! &!%C!!$ %7! +u @*+7@# a$' 111@, a$' %7! #17#al (I) l#$! +aall!l a%%7! #$!# a+!1% %7! #17#u*. I$ %7! %7# !a*+l! %7! %!*#$al &C!l "a !%!$' % %7! I +#$%#$ a 17#l' C#%7 a !1% %a%#1 u!%7al /%ula.

%7! '#%a$1!&!%C!!$ %7! "a

&u&&l! C#%7#$ %7!%!*#$al 1l$ a$'%7! +!#$!al #$(a# 1lu*$ #$ %7!'#%al !1%u*)A71a% %7 !'

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BABYGRAM

D#%#&u# "a!%!&a!, a1u*, +#$al a$*al#!(+#$a /'a 'a$ +#$al7!*#

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USG

USG a$al (+!#$!u*): +!$""a$%# #$

S+#$al ul%au$' ($!$a%u a*+a# u#a 9 &ula$):%!%7!!' +#$al 1' 'a$ a$*al# +#$al la#$

Ba$%&!" A !% al. I*+!a%! a$u: a !la%#

'#a"$!' +!$a%all@. Ultrasound Obstet Gynecol 2006;28: 904–910

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'ltrasound scan showin dilatation of the (owel and intraluminal calci)cations in an 1*+wee fetus

with imperforate anus.

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URINE SEDIMEN

La#-la#

Kl#$# !la %#'a '#'a+a%a$ /%ula

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MUS5LE STIMULATOR

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PENATALAKSANAAN

A$u %!$#: S$'a! 'a$ '#la%a#(&u#$a% H!"a)

A$u M!*&a$a: #$1## 'a$ '#la%a#

A$u

A%!#a a$# l!%a %#$""#: '#

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KOMPLIKASI

I$!# lua +!a#

S%#%u a$# Pla+ !%#

PEN0ULIT

Il!u &%u# P$!u*$#a a+#a#

E$%!l#%#

P!a#

S!+#

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REFERENSI

Hl17$!#'! AM, Hu%$ JM. 2443. A$!1%al Mal*a%#$ #$ 57#l'!$.

G!*a$. S+#$"!

L!a7lu AK. ??. MANAGEMENT OF 5ONGENITAL ANORE5TALMALFORMATIONS. Ju$al I$'#a$ P!'#a%#1. OLUME 92

E$' M !% al. A$al@# ,??2 +a%#!$% C#%7 a$!1%al *al*a%#$

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