ANORECTAL MALFORMATION

소개

ANORECTAL MALFORMATION에 관한 PPT입니다.
ANORECTAL MALFORMATION에 대해 발표하는데 적합한 자료입니다.

목차

없음

본문내용

PPT내용중 일부입니다.

ex)

Male anorectal defects

Rectoperineal fistulas
Traditionally “low defect”
Rectum: located within most of the sphincter mechanism
Only the lowest part is anteriorly mislocated
Dx: perineal inspection

Rectourethral fistulas
The most frequent defect in male pts
lower(bulbar): good-quality muscles
well-developed sacrum
prominent midline groove, anal dimple
Higher(prostatic): poor-quality muscles
abnormally developed sacrum
flat perineum, poor midline groove
barely visible anal dimple
Sx: occasionally, meconium through the urethra
→ unequivocal sign of a rectourinary fistula


Recto-bladder neck fistulas
Rectum: open into the bladder neck
10% of males with anorectal atresia
Poor developed levator m. & external sphincter
→ Poor prognosis for bowel control
Sacrum: deformed and short
Flat perineum:  evidence of poor muscle development


Imperforate anus without fistula
Rectum: approximately 2cm from the perineal skin
Well-developed sacrum and good muscles
Good prognosis for bowel function
50% : Down syndrome
More than 90% of Down syndrome and imperforate anus
→ this specific defect!


Rectal atresia
Rare: <1% of the entire group of malformations
Totally(atresia) or partially(stenosis) interrupted lumen
Upper pouch: dilated rectum
Lower pouch: small anal canal in the normal location
Repair: a primary anastomosis approached post. sagittally
Excellent prognosis: well-developed anal canal
Patients with rectal atresia must be screened for
a presacral mass

참고자료

· Ashcraft’s pediatric surgery, 5th ed. 2010, George W. Holcomb III and J. Patrick Murphy: p468-p478
· Schwartz’s Principles of surgery 9th edition, F. Charles Brunicardi et al, McGrawHill Medical,
· Townsend : Sabiston textbook of surgery 18th edition e-book: 2008