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Group 2: Leader: Hershee Izell J. Abaya Members: Rez P. Guerrero Adrian Eleazar M. Con hina Ches!

er Cruz Ri hard "i#on A$ena

here)ore !he indi a!ion )or a dis!al olono&ram is i! is done prior !o a de)ini!i$e re ons!ru !i$e sur&ery in hildren 'i!h de)un !ioned dis!al olon !o assess !he len&!h o) !he dis!al olon and iden!i)y a )is!ula. I! ser$es !o iden!i)y or on)irm !he !ype o) ARM* presen e or absen e o) )is!ulae* lea2a&e )rom anas!omoses* or pa!en y o) !he dis!al olon. Impor!an! s!ep in !he repara!i$e mana&emen! mal)orma!ions o) !he anore !al /ARMs0 'i!h imper)ora!e anus* Hirs hsprun&1s disease and oloni a!resia in hildren and obs!ru !i$e disorders o) !he dis!al olon / oli!is 'i!h s!ri !ure* ar inoma or ompli a!ed di$er!i uli!is0 in adul!s. Prior !o de)ini!i$e re ons!ru !i$e sur&ery in hildren 'i!h a olos!omy* a dis!al olono&ram is re. -. I! is also alled dis!al olo&raphy or loopo&raphy.  A small balloon a!he!er is inser!ed in!o !he dis!al s!oma* !he balloon in)la!ed* and on!ras! in+e !ed by hand !o ade. I! ser$es !o iden!i)y or on)irm !he !ype o) ARM* presen e or absen e o) )is!ulae* lea2a&e )rom anas!omoses* or pa!en y o) !he dis!al olon. I! is also alled dis!al olo&raphy or loopo&raphy.uired !o assess !he len&!h o) dis!al olon and !o iden!i)y a )is!ula.         . Impor!an! s!ep in !he repara!i$e mana&emen! mal)orma!ions o) !he anore !al /ARMs0 'i!h imper)ora!e anus* Hirs hsprun&1s disease and oloni a!resia in hildren and obs!ru !i$e disorders o) !he dis!al olon / oli!is 'i!h s!ri !ure* ar inoma or ompli a!ed di$er!i uli!is0 in adul!s.%is!al Colono&ram Meanin&:  I! is a pro edure in 'hi h 'a!er(soluble on!ras! is ins!illed in!o a de)un !ioned olon $ia a s!oma.ua!ely dis!end !he de)un !ioned loop and !he ase o) anore !al a!resia !o demons!ra!e any )is!ula.

%es endin& Colon( e#!ends )rom !he !rans$erse olon do'n'ard on !he le)! side. . Indi a!ion:  6leedin&  Abdominal pain and ons!ipa!ion  Anore !al a!resia  "e ro!izin& en!er oli!is  Hirs hsprun&1s %isease  7bs!ru !ion o) 6o'el  Presen e o) Cys!  Adhesions  E#!ra$asa!ion  Presen e o) 8is!ula .rans$erse Colon( e#!ends )rom !he as endin& olon a ross !he body !o !he le)! side. 4i&moid Colon( named i) i!s 4(shape5 e#!ends )rom !he des endin& olon !o !he re !um.3 4e !ions o) !he Colon: • • • • As endin& Colon( e#!ends up'ard on !he ri&h! side o) !he abdomen.

• .he openin& o) !he anus is missed* blo 2ed or 4!eno!i . • • • • • • • .Imper)ora!e Anus9 Anore !al A!resia • Con&eni!al • . 4i&ns and 4ymp!oms: 7penin& $ery near !o !he $a&ina.rea!men!: Re ons!ru !i$e 4ur&ery Colos!omy I) )is!ula is presen!* &i$e a broad spe !rum an!ibio!i 'i!hin !he )irs! 3<=. • .he Re !um may ha$e openin& !o !he o!her s!ru !ures • :RARE. "o Me onium 'i!hin )irs! 23(3<= 4'ollen 6elly 4!ool passes ou! o) !he >a&ina9 6ase o) !he Penis Missin& Anus .he Re !um may no! onne ! !o !he Colon.

Aea2 'all o ur due !o !he ora&n is imma!ure and lo' blood supply* !his supply &oes !o $i!al or&ans ins!ead o) Gas!roIn!es!inal ."e ro!izin& En!ero oli!is • • • • • • • • • Prema!ure in)an!s durin& ?s! 2 'ee2s o) li)e* 'hen mil2 )eedin& has be&un* !hru "G. 4i&ns and 4ymp!oms: • Abdominal %is!en!ion • 6lood in !he 4!ool • %iarrhea • 8eedin& In!oleran e • .. air in !he bo'el 'all in 4mall In!es!ine Lon& se&men! usually.ra !* !hus ma2in& i! 'ea2.emper Ins!abili!y • Le!har&y • >omi!!in& . 2nd mos! morbidi!y in prema!ure in)an! Idiopa!hi %ue !o 'ea2 mu osal in!e&ri!y !he ba !eria an in$ade !he 'ea2 'all and &e! in)e !ed. @ lbs baby Por!ions o) bo'el under&o ne rosis.

rea!men!: • 4hor! 4e&men!: Rese !ion o) !he A&an&lioni 4e&men! 'i!h Anas!omosis.• • Colos!omy Ileos!omy on Bray: 6ubbly Appearan e o) !he &as in !he 'alls o) in!es!ine Hirs hsprun&Cs %isease /Con&eni!al In!es!inal A&an&lionosis0 is a disorder o) !he abdomen !ha! o urs 'hen par! or all o) !he Lar&e In!es!ine or an!e eden! par!s o) !he Gas!roin!es!inal . • Lon& 4e&men!: Colos!omy Con!raindi a!ion:     Pa!ien! un'illin& !o &i$e onsen! Hn oopera!i$e pa!ien! 8ulminan! oli!is Pre&nan y .ypes • 4hor! 4e&men! ( Las! 4e&men! o) Lar&e In!es!ine /<EF ME"0 • Lon& 4e&men! ( Mos! o) !he Lar&e In!es!ine /2EF ME" G A7ME"0 .he Colon anno! rela# and pass s!ool !hrou&h !he olon rea!in& an obs!ru !ion.ra ! ha$e no ner$es and !here)ore anno! )un !ion. an be on)irmed !hrou&h su !ion biopsy o) Re !al Mu osa 'hi h is sen! )or y!o&ene!i analysis. Common in 6oys /?9DEEE0 4i&ns and 4ymp!oms: • Abdominal Pain • Ribbon li2e 4!ool • Poor 8eedin& 2 . • • • • • Harold Hirs hsprun& A&an&lioni Me&a olon .

. Distal colitis* po!en!ially !rea!able 'i!h enemas: • Pro !i!is: In$ol$emen! limi!ed !o !he re !um. • "on rela!ed !o an In!es!inal In)e !ion9 "4AI%4 • i! is in !he Re !um and an e#!en! pro#imally in a on!inuos )ashion. • Proctosigmoiditis: In$ol$emen! o) !he re !osi&moid olon* !he por!ion o) !he olon ad+a en! !o !he re !um.Hl era!i$e Coli!is • In)lamma!ory 6o'el %isease. • Re urren! in In)lamma!ion o) !he Mu osal Layer o) !he Lar&e 6o'el.

Left-sided colitis: In$ol$emen! o) !he des endin& olon* 'hi h runs alon& !he pa!ien!Cs le)! side* up !o !he spleni )le#ure and !he be&innin& o) !he !rans$erse olon. • • • In)lamma!ion is Chara !erized by Hl era!ion.enderness9 %is!en!ion • Anemia . Extensive colitis* in)lamma!ion e#!endin& beyond !he rea h o) enemas: • Pancolitis: In$ol$emen! o) !he en!ire olon* e#!endin& )rom !he re !um !o !he e um* beyond 'hi h !he small in!es!ine be&ins.enesmus /ur&en! desire !o e$a ua!e s!ools bu! 'i!h li!!le passa&e o) i!0 • Lo'er Abdominal Pain • I 3# 9 day bo'elsJ I! an lead !o 8ulminan! Coli!is 4i&ns and 4ymp!oms: • ?E# 9 day bo'els • Con!inuous 6leedin& • Abdominal . Idiopa!hi Ris2 8a !or: • Gene!i s • E!hni i!y • Ci&are!!e 4mo2in& • %ie! • Iso!rerinoin 4i&ns and 4ymp!oms: • Re !al 6leedin& /6ri&h! Red0 • .

I! help relie$e in)lamma!ion • %e#ame!hasone An an!i in)lamma!ory a&en!.I • Passa&e o) Hrine in !he Re !um • Pneuma!uria Lo a!ion: • A! !he pos!erior par! o) !he 6ladder. . Mos! Common Cause %i$er!i uli!is 4i&ns and 4ymp!oms: • 8e alisis • Re urren! H. Colo$esi al 8is!ula9 Re !o$esi al 8is!ula9 >a&ino$esi al 8is!ula • Presen e o) Communi a!ion be!'een !he Colon and 6ladder. Medi a!ion: • Rese !ion o) !he 8is!ula and A6 4e&men! o) !he 6o'el is re.uired )or Anus. 4!eroid may be added i) symp!oms on!inues.Medi a!ion: Mesalamine /lialda0 Amino 4ali yla!es • Relie$e in)lamma!ion o) in!es!ines and help pre$en! re urren e.

"o!i)y !he physi ian i) !here is any suspe !ed pre&nan y.ues!ions i) some!hin& is un lear. "o!i)y !he physi ian o) all medi a!ions /pres ribed and o$er !he oun!er0 and herbal supplemen!s !ha! !he pa!ien! has !a2en or is !a2in&.he pa!ien! 'ill be as2ed !o si&n a onsen! )orm !ha! &i$es permission !o do !he pro edure.he pa!ien! should read i! are)ully and as2 . . .Pa!ien! Prepara!ion:    8as!in& o) a! leas! < hours "o bo'el prepara!ion . .he physi ian 'ill !emporarily 'i!hhold su h medi a!ions prior !o !he pro edure.he physi ian 'ill e#plain !he pro edure !o !he pa!ien! and o)) !he pa!ien! !he oppor!uni!y !o as2 . "o!i)y !he physi ian i) !here is hypersensi!i$i!y !o any medi a!ion* la!e#* !ape and anes!he!i a&en!s /lo al and &eneral0.ues!ions !ha! are rela!ed !o !he pro edure. .he pa!ien! 'ill be as2ed !o han&e lo!hes and 'ear a pa!ien! &o'n Prior !o Pro edure:      .

ues! o!her spe i)i prepara!ion.  (74 /opera!in& spon&e0  Co!!on balls  4!erile Nidney 6asin  Aspira!in& needle G?<  CM non ioni  . Ma!erials: 8oley a!he!her ( ( ( ( 4ize o) 8C per a&e: ? day old !o ? mon!h K )?E 2 mon!hs !o L mon!hs K )?3 M mon!hs !o 2 years oldK )?L @ years !o abo$e K )?<  D syrin&e  LE syrin&e /asep!o syrin&e0  Glo$es  NO +elly  Plas!er /leu2oplas!0 ?. 6ased on !he pa!ien!s ondi!ion* !he physi ian mi&h! re.

As2 !he do !or 'hen !o s!ar! !he pro edure . As2 !he do !or !o he 2 !he ima&e be)ore pro eedin& !o !he pro edure.Con!ras! Media   6arium 4ulpha!e Aa!er 4oluble Pro edure: A mar2er is pla ed o$er !he anal dimple or !he e#pe !ed posi!ion o) !he anus. Ano!her mar2er is pla ed a! !he poin! 'here urine or )e al ma!erial is seen !o be dis har&in&.

Ima&es are ob!ained under )luoros opy. -CR is a! !he le$el o) !he L3 or a! !he le$el o) !he ilia res! .he dis!al blind end o) !he olon &e!s )illed pro&ressi$ely and pressure is main!ained !ill !he on!ras! )ills !he )is!ulous !ra !. Le)! La!eral -6es! demons!ra!e !he :up.he !rans$erse olon should be primarily barium( )illed on !he PA and air()illed on !he AP 'i!h a double( on!ras! s!udy. . Aa!er(soluble on!ras! is used. En!ire lar&e in!es!ine* in ludin& !he le)! oli )le#ure* should be $isible. medial side o) !he as endin& olon and !he la!eral side o) !he des endin& olon* 'hen !he olon is in)la!ed 'i!h air due !o &ra$i!y.     . In adminis!erin& !he Cm* pa!ien! 'ill be as2ed !o han&e posi!ion. Ri&h! La!eral -6es! demons!ra!e !he :up.* medial side o) !he des endin& olon and !he la!eral side o) !he as endin& olon* 'hen !he olon is in)la!ed 'i!h air.he a!he!er !hrou&h !he s!oma leadin& !o !he dis!al olon* i!s balloon is in)la!ed and i! is pulled ba 2 durin& in+e !ion o) !he on!ras! !o a$oid any spilla&e. -CR a! !he le$el o) !he L3 or a! !he le$el o) !he ilia res! PA or AP Pro+e !ion  4!ru !ures 4ho'n: .