The management of atresia ani

The management of atresia ani dependent classification:
1. Perform digital rectal examination
2. Radiological examination x-ray examinations helpful in the effort to locate the end of the rectum is deadlocked after 24 hours old, the baby should be placed in circumstances upside down for three minutes, the hip joint in a state of extension and made a little photo anteroposterior and lateral views after the marker is placed in the indentation area anus.
3. Neonatal colostomy Doing this action must be taken immediately if there is no evacuation of meconium.
4. In severe stenosis needs to be done every day with a catheter dilatation of the urethra, dilatation Hegar, or small nasal speculum then parents can do yourself at home with dilatation of the fingers made during the 6 months to soften the area stenosis and defecation functions reach normal state.
5. Anapelasti perineal surgery followed by a dilatation of the rectum's new in the disorder type two.
6. In the three types of abnormalities through anoproktoplasti reconstructive surgery during the neonatal
7. Reconstructive surgery, among others: abdominoperineum surgery at the age (1 year) posterior sagittal anorektoplasti surgery at the age of (8 -! 2 months) approach to the sacrum after the baby is old (6-9 months)
8. Handling type four performed with a colostomy and then proceed with the operation of "abdominal pull-through" benefits colostomy is among others:
a. Overcoming intestinal obstruction
b. Allows reconstructive surgery to be done with a clean operating field
c. Gives a chance on the surgeon to perform a complete examination in an attempt to determine the position of the rectal stump appendicitis and find other congenital disorders.
Defries FEnA and in 1982 introduced the method of operation with sagittal anorectoplasty postero approach, ie by splitting muscular muscular sphincter and levator ani eksternus to facilitate mobilization of the rectum and cutting bag fistel. The successful management of atresia ani was assessed from the long-term functions, including anatomic, physiological function, the form of cosmetics as well as anticipation of psychic trauma. As Goalnya is regularly defecate and good consistency. To handle it properly, should ditentukankan height suffix rectum which can be determined in various ways such as by physical examination, radiological and ultrasound.
Postoperative complications occurred mostly caused by the failure to locate their colostomy, surgery is not adequate preparation limited knowledge of anatomy, a less operator skill and poor postoperative care. Of the various classifications Rx differ depending on the location of the height of the suffix rectum and presence or absence of fistula.
The latest techniques of this operation is the technique of atresia ani sagittal postero Recto Ano Plasty (PSARP). This technique has high accuracy to open the patient's buttocks crease. This technique is the replacement of the old technique, namely Abdomino perineal Through Poly (APPT). This old technique had a high risk of failure because they have to open the abdominal wall, causes a lot of fecal incontinence and prolapse of the intestinal mucosa is higher.
Technical Operations
 Performed with general anesthesia, with endotracheal intubation, the patient's position on his stomach and pelvis elevated
 Stimulation of the perineum with the Pen tool to identify anal Muscle Stimulator Dimple
 Incisi the middle of the sacrum towards the bottom through the center and stopped 2 cm spingter didepanya
 split subcutaneous tissue, fat, and muscle fiber parasagital complek.
Os Coxigeus split up to look muscular levator, and the muscular levator cleaved looked back wall rectum
• rectum relieved from the surrounding tissue
• withdrawn rectum through the levator, and parasagital complek muscle fiber
• Conducted anoplasti and maintained not to tension.