Akut Abdomen

7/17/2019 Akut Abdomen

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Oleh : Dr. Akhmad Makhmudi, Sp BAMata kuliah: Ilmu Bedah III (Smt VIII)

Jumat, 31 Desember 2004



ASUS BEDAH ANA

( ONGENITAL)

ILEUS MEGAKOLON

HIGROMA COLLI



A.OMPHALOCELE B. GASTROSCHIZIS

C.TUMOR D. ATRESIA ANI



RESPIRATORY DISTRESS

SYNDROME (RDS)

AA!"MI : Diameter lume#

ke$il, k%sta lebih h%ris%#tal&

th%rak ke$il da# sem'it,

'er#a'asa# abd%mi#al, "2

0 lebih ti#**i+

!ADA DS - !a$h.'#ea,

$.a#%sis, d.s'#ea



AKUT ABDOMEN

I/S

S!A/ASI

I!"I!IS DAAA

5"MBIASI&!AMA

I/S: "B/M5"MSI&DIDASI

DA I65SI



SIMPTOM AND SIGN

SAKIT PERUT

OBSTIPASIKEMBUNG

MUNTAH

ABDOMINAL SIGN



KAUSA SAKIT PERUT

(ABDOMINAL PAIN)

NONORGANIK: EMOSINAL,

KELAINAN SUSUNAN SARAFPUSAT,ORGAN INTRA ABDOMINALNORMAL

ORGANIK: KELAINAN ORGAN

INTRAABDOMINAL DAN DINDINGABDOMEN



SAKIT PERUT-MANIFEST KELAINAN

ORGANIK INTRAPERITONEUM SAKIT KOLIK (COLICKY/

CRAMPING PAIN- SIMPLE

OBSTRUCTION) -

SAKIT TERUS-MENERUS (CONSTANS

PAIN- ISCHEMIC TISSUE)

REFERRED PAIN NERVUS TH X

NYERI RANGSANGAN

PERITONEAL ( DEFANS

MUSCULER)



OBSTRUKSI USUS STRANGULASI-

VOLVULUS EUNUM



APPENDICOGRAM

APPENDICITIS !

GRADE:

I SIMPLEOBSTRUCTION

II SUPPURATIVE

III GANGREN IV RUPTURE

V ABSCES



CECAL ILEUS

RETENSI SISA BARIUM DIDALAM SEKUM

DAN LUMEN APPENDIKS



OBSTRUCTION

DEFINITION: SINDROME GANGGUAN PASASEORGAN BERSALURAN

ORGAN BERSALURAN: ". INTESTINUM

#. DUCTUS BILIARIS

$. DUCTUS PANCREATICUS

%. URINARY TRACT !. TUBA FALLOPII

I L E U S



I L E U S

( INTESTINAL OBSTRUCTION )OBSTRUCTION : YES/ NO

SIMPLE OR STRANGULATION

HIGH OR LO& OBSTRUCTION

PARTIAL OR TOTAL

MECHANIC OR FUNCTIONALSYSTEMIC COMPLICATION

LOCAL COMPLICATION



HIGH GIT OBSTRUCTION

GASTRIC OUTLET OBSTRUCTION

- HPS ( HYPERTROPHIC PYLORIC STENOSIS )

- ANTHRAL &EB - PYLORIC MUCOSA PROLAPS

DUODENAL OBSTRUCTION

- ATRESIA/STENOSIS DUODENUM - PANCREAS ANNULARE

- LADD'S MEMBRANE



MECHANICAL LO&ER GIT

OBSTRUCTION

MECONIUM ILEUS MECONIUM PLUG SYNDROME

NEONATAL SMALL LEFT COLON SYN DROME MALROTATION &ITH VOLVULUS INCARCERATED HERNIA EUNOILEAL ATRESIA

COLONIC ATRESIA INTESTINAL DUPLICATION INTUSSUSCEPTION N E C



FUNCTIONAL LO&ER GIT

OBSTRUCTIONSEPSIS

INTRACRANIAL HEMORRHAGE

HYPOTHYROIDISM

MATERNAL DRUG INGESTION OR

ADDICTION

HYPERMAGNESEMIA

HYPOKALEMIA



THIRDS SPACE SYNDROME

APA PERBEDAAN DAN PERSAMAAN

KASUS GASTRO ENTERITIS DAN ILEUS



PROBLEM ILEUS



PROGNOSIS

ILEUS LETAK TINGGI

ILEUS LETAK RENDAH



GIT HAEMORHAGE

UPPER : MELENA

LO&ER : HEMATOCHEZIA RECTAL BLEEDING

LIGAMENTUM TREITZ LIMITED



TERAPI NUTRISI PARENTERAL

BB AS : 7AIA SSI!ASI /8 ASI

6/"9 AS : 7AIA !ISI 5 : D, D10

"!I : ASAM AMI" 2,, ,10

/MA5 : /IID 20

/5!"/I!: 5A I B, 3A, 3B

MIA/



"AM 7AIA :( JAM )

1+JM/A 7AIA2+JIS 7AIA

3+7AA MBIA

4+M"I!"I



*+ 01 :

1+ De;isit $aira# 8 dehidrasi

a+ Dehidrasi i#*a# : ( 0ml8k*bb < !B9 )

b + Dehidrasi Seda#* : 10 (100ml8k*bb < !B9 )

$+ Dehidrasi Berat : 1 (10ml8kbbb < !B9 )= !%#isitas darah:i'%t%#is,is%t%#is,hi'ert%#is

2+ Mai#te#a#$e

e%#atus: 24 >am '%st %'erati; dikura#*i 30

3+ erkiraa# $aira# hila#* dalam 24 >am( %# *%i#* l%ss )

2?3 m%di;i$ati%# t% 6luid i#take ( see table )



TOTAL BODY WATER ( ASHCRAFT )

M

estasi%#al @ 12 mi#**u 4

12 mi#**u @ 32 mi#**u 0

Aterm

3& hari C

&3 @

e%#atus C &

0

7hildre# &C

%u#* Ma# 0

%u#* 9%ma# 0

"Eer 0 .ears ma# 0"Eer 0 .ears F%me# 4



MAINTENANCE ( ASHCRAFT ) = Dail. 6luid eGuireme#ts

&234 V5+*2

P02*402 (6 #73 ) "!8 *+ / 73

N25149 1;14 (#-"8 73 ) "88*+/73 ;50 ;094 "873

I1;14 +<021 ("8-#873 ) "888*+=!8*+/73 5>20 "8 73

C+<021 ( ? #8 73 ) "!88*+=#8*+/73 5>20 #8 73





I10292

6ull a$tiEit. H %ral ;eeds 1+

6eEer H 12 'er 7

%%m tem'erature 31 7 H 30 'er 7

.'erEe#tilati%# 1+2e%#ate & 'reterm (1&1+ k* ) 1+2

& radia#t heater 1+

& 'h%t% tera'. 1+

Bur# & ;irst da. H 4 'er 1

area bur# & SubseGue#tl. H 2 'er 1

area bur#



NAMA PRODUK OSMOLARITAS N,= C+- K= C,== A924,42 L,4,42- G+)759, K,+50 KEMASAN

*O9*/L K,+/LK,2N " B #@# $@.! $@.! $.! "!8 !88

K,2N $ A #8 8 !8 "8 #8 # "8@ !88

K,2N $ B #8 !8 !8 #8 #8 # "8@ !88

K,2N MG$ ! !8 !8 #8 #8 "88 %88 !88

!88/"888

A92013 #$.% "$8 "8@. % #. #@ !88

KOMPOSISI ELEKTROLIT ( mEq/L )

KOMPOSISI LARUTAN KA EN DAN ASERING



D/940/)4/51 C5*E,0,4/>2 :

K5*E,042*21 U*)0

N251,4)9 C-/+<021 A<)+4

70S lasma : 1 1 2 1

I#tersisil : 3

7IS 1 3 2

Transeluler : 1 % - 3 % BB



AD : a#tidiureti$ h%rm%#e

I : i#termitte#t '%sitiEe 'ressure Ee#tilati%#

INSENSIBLE &ATER LOSS

mur e%#atus 8k*bb8hr mr 8k*bb8hr

dara bebas ta#'a kelembaba# 2 $$ Ba.i (0&0 $$

umidi;ied is%lette 14 $$ A#ak 40 $$

ema#asa# 40 & 4( $$ ,ema>a 30 $$



KASUS :

PASIEN BAYI USIA %8 HARI(BB %KG)

DENGAN ILEUS DISERTAI DEHIDRASI

BERAT DAN FEBRIS SUHU %88

C,ASIDOSIS METABOLIK DAN ANEMIA.

HASIL LAB.HB @G, ALBUMIN # G/DL, K=

# ME/L, NA= "8 ME/L, TROMBOSIT

!8888 MM# /DL. TERANGKAN PENATALAKSANAAN

LENGKAP



Akut Abdomen

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