Page 376 - Abstract Book KONIKA 18

Pediatric Imaging

P-PI-013
Ultrasound Diagnosis for Type-1 Neonatal Sacrococcygeal Teratoma:
A Case Report

Dara Indira Diniarti , Resita Sehati , Evita Karianni Bermashah 2
1
2
2
Department of Child Health and Pediatric Imaging Division, Departement of Child Health ,
1
Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Abstract
Background Sacrococcygeal teratomas (SCTs) are the most common germ cell tumors in neonates occurring
in 1 of 27,000 live births. The majority of SCTs are benign but can progress or recur as malignant. Prompt
surgical resection is required and imaging studies play an important role in confirming the diagnosis.
Objective To demonstrate ultrasound (US) evaluation for diagnosis of type-1 neonatal SCT Case An aterm
baby girl born via C-section with suspected SCT by antenatal US at 16-weeks gestation. A cystic mass (18
x16 x 10 cm) was found arising asymmetrically at sacrococcygeal region. There was normal external genitalia
and anterior displacement of the anus. The US investigation found predominantly cystic mass with a few
solid part came from the pelvic space and no deformities in vertebrae. This finding classified as type-1 of
Altmans classification. Complete excision and coccygectomy was performed entirely through the posterior
route on the 17th day of life and was tolerated well by the infant. The histology examination confirmed a
mature teratoma, consistent with the US finding. Conclusion This case was considered as type-1 SCT with
benign profile from the US investigation and confirmed by the histology evaluation. Ultrasound investigation
can be used as a first imaging modality for confirming the diagnosis and to manage of SCT tumor properly.
The MRI is recommended where available.
Keywords: ultrasound; sacrococcygeal teratomas; neonate

P-PI-014
Imaging Features of Rectal Atresia

Naela Fadhila, Resita Sehati, Haryanti Fauzia Wulandari
Pediatric Imaging Division, Departement of Child Health,
Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Abstract
Background Rectal atresia is an extremely unusual type of anorectal malformation that is associated with
a normal anal canal but a variable rectal segment is atretic. Usually, there is no fistula between the rectum
and the urethra or vagina. The reported incidence is 1-2% of all anorectal anomalies. Early assessment and
accurate diagnosis to differentiate with another anorectal malformation are essential for determining treatment.
Objective To show imaging features of rectal atresia. Case A case of 32 weeks gestational age baby conjoined
twins abdominal-abdominophagus with a single viable female baby has no history of passing meconium since
birth. A separation surgery was performed early after birth. On the 12-hours physical examination, abdomen
was distended. Careful examination revealed normally placed anal opening, perineum and genitalia. Plain
radiograph of abdomen and supine cross-table lateral view showed gastric dilatation, minimal intestinal
gas pattern that not reached the minor pelvic by 15 hours-age, suspected rectal/colonic anomaly. Contrast
enema revealed an atretic inferior rectal segment with a superior rectal pouch with no fistula, correspond
to rectal atresia diagnosis. Trans perineal ultrasonography was performed to determine the precise type of
anatomic defect. It visualized the gap between anal opening and the rectal pouch that was consistent with
rectal atresia. Conclusion Failure to pass meconium and progressive abdominal distention in the early life
may suggest intestinal obstruction in neonates whether anal is visibly developed. Rectal atresia is a rare
congenital malformation that can be detected by various imaging modalities.
Keywords: rectal atresia; contrast enema; trans perineal ultrasonography

328 KONIKA XVIII Abstract Book