Page 381 - Abstract Book KONIKA 18

Pediatric Imaging

P-PI-022
Role of Sacral Index in Anorectal Malformation:
A Case Report of Newborn in Cipto Mangunkusumo Hospital

1
2
Maulana Rosyady , Resita Sehati , Evita Karianni Bermanshah 2
2
1
Department of Child Health and Pediatric Imaging Division, Departement of Child Health ,
Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Abstract
Background Anorectal malformation are congenital anomalies involving the distal anus and rectum as
well as the urinary and genital tracts in a significant number of cases. It occur approximately in 1 in every
5000 live births. They are slightly more common in males (1.2 to 1). Pena developed sacral index (SI)
with pelvic radiograph as a modality, a point of reference to detect the sacral dysplasia in patients with
anorectal malformation. Measurement lines and calculation of the sacral index in AP and lateral projections
with a normality standard parameter of 0.74 in the frontal projection and 0.77 on the lateral projection.
Objective To show the role of sacral index in newborn baby with anorectal malformation. Case A newborn
baby girl was admitted to our hospital with no meconium after 24 hours and suspected with anal atresia. She
was born from a healthy mother with unknown antenatal care. She was delivered at home without help from
medical supervisor. She cried spontaneously after birth. There is no history of congenital anomalies in her
siblings. On physical examination was found anterior displacement of the anus. Pelvic radiograph review
sacral index on lateral projection was 0,62 and frontal projection was 0,66. It showed anorectal malformation.
Conclusion Sacral index can be used as screening tools of anorectal malformation especially in rural area.
Although SI showed wide range of values in both healthy or in anorectal malformation children, it still give
promising information if obtain correctly.
Keywords: sacral index; pelvic radiograph; anorectal malformation

P-PI-23 (Prime e-Poster)
Reverse X-Ray Imaging to Identify Peripherally-Inserted Central Catheters Tip
in Neonates: A Case Series

2
Nitish Basant Adnani , Resita Sehati , Evita Karianni Bermanshah 2
1
2
1
Department of Child Health and Pediatric Imaging Division, Departement of Child Health ,
Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Abstract
Background Peripherally-inserted central catheters (PICC) are commonly used in neonates to provide
a secure intravenous access to deliver nutrition and medications. Confirmation of the PICC tip position
is crucial, and is commonly performed using radiographic imaging. However, not all PICC tip position
can be easily visualized using this method and sometimes additional modifications can be warranted.
Objective To present the benefits of using reverse X-ray imaging to promote better visualization of PICC
tip position. Cases Four pairs of radiographic images were evaluated with conventional and reverse X-ray
imaging to determine the PICC tip position. The cases provide examples of PICC placement that were too
deep, too shallow, or having a false route, which were not easily visualized using conventional X-ray imaging.
However, these appeared more clearly using reverse X-ray imaging, which allows better visualization of PICC
tip malposition in order to prevent its various complications such as cardiac arrhythmias, bleeding, infections,
blood clots, as well as damage and extravasation of peripheral blood vessels. Conclusion This case series
showed that reverse X-ray image can be beneficial in providing better visualization of PICC tip in neonates.
Keywords: reverse X-ray image; peripherally-inserted central catheter; neonate

KONIKA XVIII Abstract Book 333