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GC : crying, active
HR 152 x/mnt,RR:48 x/mnt,suhu: 37.2C
BB : 3300 Gram
Head : anemis(-),ikterik (-), suction reflex
(+), nostril breathing (-),
salivasi(+). OGT was attached.
Neck : lymph nodes enlargement (-)
Chest : Simetris, subcostal retraction (-).
Heart : I-II Heart sound, murmur (-).gallop (-)
Lung : Sonor+/+,vesikuler +/+,slem -/-
ronki -/-, Wheezing -/-
Abdomen : distension (-), peristaltic(+), surgical
wound covered by verband, abdominal catheter attached
draining out brownish-yellow fluid
Anus : (+)
Plain radiograph
Chest:- esophageal atresia
- Segmental pneumonia in superior lobe right lung
(aspiration?)
- Normal heart size
Abdomen: - minimal air-filling in pelvis/rectum
- air-filled small intestine
Conclussion : torako abdomen VACTERL disease
Laboratory finding:
Hb 12.1/38/11600/341000
Electrolit : Na 135 K 5.7
Blood glucose : 75
ASA III
ANESTHETIC MANAGEMENT
Preanesthetic Management
Preoxygenation
Monitoring : saturation , ECG and placed precordial
stethoscope on left axillary area
Intraoperative
Head up position
All intake nutrition given by parenteral route