Sering pada bedah anak dengan angka kejadian 1 dalam kelahiran hidup. Background: Anorectal malformation (ARM) are congenital malformation. Diagnosis serta Manajemen Malformasi Anorektal pada Laki-laki (Klasifikasi Para ahli bedah anak telah menemukan beberapa teknik operasi untuk malformasi anorektal. Assessment of postoperative results in malformation anorectal. Although less common in Western societies, pediatric rectal prolapse is a Hirschsprung disease, high anorectal malformations, cystic fibrosis, Missing: anak | Must include: anak.
|Author:||Patricia Wisozk III|
|Published:||22 April 2015|
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|Uploader:||Patricia Wisozk III|
Anorectal malformations occur in approximately 1 in live births and affect males and females almost equally. The embryologic basis includes failure of descent of the urorectal septum. The level to which this septum descends determines the type of anomaly malformation anorectal pada anak is present, which subsequently influences the surgical approach.
In patients with imperforate anus, the rectum fails to descend through the external sphincter complex.
Instead, the rectal pouch ends blindly in the pelvis, above or below the malformation anorectal pada anak ani muscle.
In most cases, the blind rectal pouch communicates more distally with the genitourinary system or with the perineum through a fistulous tract. Traditionally, anatomic description of imperforate anus has been characterized as either "high" or "low," depending on whether the rectum ends above the levator ani muscle complex or partially descends through this muscle Fig.
Based upon this classification system, in male patients with high imperforate anus, the rectum usually ends as a malformation anorectal pada anak into the membranous urethra. In females, high imperforate anus often occurs in the context of a persistent cloaca.
In both males and females, malformation anorectal pada anak lesions are associated with a fistula to the perineum. In males, the fistula connects with the median raphe of the scrotum or penis. In females, the fistula may end within the vestibule of the vagina, which is located immediately outside the hymen, or at the perineum.
Low imperforate anus in a male. Note the well developed buttocks. The perineal fistula was found at the midline raphe. Because this classification system is somewhat arbitrary, Pea proposed a classification system that specifically and unambiguously describes the location of malformation anorectal pada anak fistulous opening.
In males the fistula may communicate with: In females, the urethra may open onto the perineum between the female genitalia and the center of the sphincter cutaneous perineal fistulaor into the vestibule of the vagina vestibular fistula Fig.
In both sexes, the rectum may end in a completely blind fashion imperforate anus without fistula. In rare cases, patients may have a normal anal canal, yet there may be total atresia or severe stenosis of the rectum. Imperforate anus in a female. A catheter has been placed into the malformation anorectal pada anak, which is malformation anorectal pada anak thevestibule of the vagina.
The most frequent defect in males is imperforate anus with rectourethral fistula, followed by rectoperineal fistula, then rectovesical fistula or rectobladder neck. In females, the most frequent defect is the rectovestibular defect, followed by the cutaneous perineal fistula.
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The third most common defect in females is the persistent cloaca. This lesion represents a wide spectrum of malformation anorectal pada anak in which the rectum, vagina, and urinary tract meet and fuse into a single common channel. On physical examination, a single perineal orifice is observed, and is located at the place where the urethra normally opens.