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患儿,男,2天,自出生后即开始腹胀,渐加重,精神差、拒乳,无呕吐,伴发热体温29℃,后发现患儿无肛门,门诊以“先天性无肛门”收住院。体检:体温40℃,精神差,心肺未见异常,腹高度膨胀,可见腹部静脉显露,腹壁红肿,未见胃肠型,肠鸣音弱,会阴部无肛门开口。腹部倒立位平片:直肠盲端距肛门皮肤约1.6cm,诊断:先天性中位无肛。行会阴肛门成形术,拖出直肠,有少量胎粪排出。术后应用青霉素、氨苄青霉素,但仍高热,拒乳,腹胀不缓解,术后第二天腹胀加重,腹透发现膈下大量游
Children, male, 2 days, since the birth began to bloating, getting worse, poor spirit, refusing milk, no vomiting, fever with a temperature of 29 ℃, and found no anus in children, outpatient “congenital anus” admitted to hospital . Physical examination: body temperature 40 ℃, poor spirit, no abnormal heart and lungs, abdomen height expansion, visible abdominal veins revealed abdominal wall swelling, no gastrointestinal type, bowel sounds weak, perineal no anal opening. Abdominal inverted flat film: Rectal blind end from the anal skin about 1.6cm, diagnosis: congenital anorexia. Perineal anal angioplasty, dragged out of the rectum, a small amount of meconium discharge. Postoperative penicillin, ampicillin, but still hot, refused to milk, abdominal distension does not ease, abdominal distension increased the day after surgery, found a large number of diaphragmatic peritoneal dialysis