usg trasnperineal
DESCRIPTION
1TRANSCRIPT
Objective : Menilai apakah USG transperineal valid dan accurate untuk menetukan atresia ani, low(translevator) type dari intermediate and high (supralevator) type.Perbedaan type atresia ani berpengaruh dalam jenis operasinya.
Material and methods :56 infants (usia 0-90 hari) dengan atresia ani, dilakukan USG transperineal dengan probe linier 12 MHz. Mengukur jarak distal rectal pouch dengan perineum dan mengidentifikasi cutoff distance untuk perbedaan type atresia ani.Membandingkan temuan USG dan Pembedahan.
Result :USG trasnperneal dpt dilakukan ke semua anak tanpa persiapan khusus.22 infant dengan atresia ani low type.34 infant dengan intermediate or high type.Cutoff 15 mm.Sesitivity 100%, Specifity 86%, Accuracy 95%
Conclusion :USG trasnperineal merupakan pemerikasan non invasive yang valid dan accurate untuk membedakan atresia ani low type and intermediate or high type.
Trasnslevator (low) type one-step transperineal anoplasty soon after birth.
Supralevator (intermediate and high) the appropriate surgical procedure for both types consists of initial diverting colostomy followed by the posterior sagittal anorectoplasty (PSARP).
Patients January 1996 – August 200656 infant (30 boys, 26 girl) range 0-
90 days↓
46 infant < 28 days old11 infant had undergone colostomy
before USG
Imaging12 MHz linear array transducerThrough transperineal approachBy 2 sonologists, with more than 15
years exp
Position supine midsagittal plane perineum ident : bladder, urethra, vagina, distal rectal pouch.
Performed while child was not crying
Not press skin or indent the skin because can diminish the distance between the distal rectal pouch and the perineum
Colostomy inj. hydrosoluble contrast through the distal stoma lateral position identification rectourogenital fistula
Low Type : 22 infant 16 infant with anocutaneous fistula This group was 10±4 (SD) mm, range 5-
17 mm. Intermediate or High type : 34 infant
17 infant intermediate distance 16-37 mm
17 infant High distance 18-35 mm