Download - A. Obstruksi Usus
-
7/23/2019 A. Obstruksi Usus
1/20
INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION
SISTEM ALIMENTARISISTEM ALIMENTARI
SUBJEK PEMBEDAHANSUBJEK PEMBEDAHANKOD MAGS 1213KOD MAGS 1213
-
7/23/2019 A. Obstruksi Usus
2/20
OBJEKTIF
1. Menyatakan definisi IO
2. Menerangkan etiologi IO
3. Menerangkan jenis IO4. Menerangkan ciriciri klinikal IO
!. Menerangkan jenisjenis in"estigasi
#. Menyatakan ko$%likasi IO
&. Menerangkan %eng'r'san IO
-
7/23/2019 A. Obstruksi Usus
3/20
INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION
** Halangan kepaa pe!ge!akan keHalangan kepaa pe!ge!akan ke "aapan #$%!&a! pa''age( )akanan"aapan #$%!&a! pa''age( )akanan
na+,' an $la-.'/na+,' an $la-.'/
** Seka-an paa .'.' ke0,l a-a. k%l%nSeka-an paa .'.' ke0,l a-a. k%l%n
ang )eng"alang )akanan an 0e0a,!ang )eng"alang )akanan an 0e0a,!
)elal.,na/)elal.,na/
-
7/23/2019 A. Obstruksi Usus
4/20
INTESTINAL OBSTRUCTIONINTESTINAL OBSTRUCTION
KLASIIKASIKLASIIKASI
1/ AKUT1/ AKUT KRONIKKRONIK
2/ TINGGI2/ TINGGI RENDAHRENDAH3/ PARTIAL3/ PARTIAL COMPLETECOMPLETE
4/ SIMPLE4/ SIMPLE STRANGULATEDSTRANGULATED
-
7/23/2019 A. Obstruksi Usus
5/20
ETIOLOGIETIOLOGI
#a00%!,ng -% age(#a00%!,ng -% age(
1/1/ NEONATESNEONATES
I)pe!$%!a-e an.' #ke-e!5.kaan(I)pe!$%!a-e an.' #ke-e!5.kaan(
6%l7.l.'6%l7.l.' C%ngen,-al a-!e',a #Pene)p,-an(C%ngen,-al a-!e',a #Pene)p,-an(
Me0%n,.) ,le.'Me0%n,.) ,le.'
H,!'0"'p!.ng' ,'ea'eH,!'0"'p!.ng' ,'ea'e
#k%ngen,-al 8 !ek-.) 9 k%l%n#k%ngen,-al 8 !ek-.) 9 k%l%n
5a&a"5a&a" : 5e!$.ng',(: 5e!$.ng',(
-
7/23/2019 A. Obstruksi Usus
6/20
CHILDRENCHILDREN
Pl%!,0 '-en%','/Pl%!,0 '-en%','/
In-.''.'0ep-,%n #-ele'0%pe(In-.''.'0ep-,%n #-ele'0%pe(
Pa!a',-e'Pa!a',-e'
%!e,gn 5%,e'%!e,gn 5%,e'
;OUNG 9 MIDDLE AGED ADULTS;OUNG 9 MIDDLE AGED ADULTS
P%'-%p A"e',%n' < 5an' P%'-%p A"e',%n' < 5an'
S-!ang.la-e "e!n,aS-!ang.la-e "e!n,a
Pa!al-,0 ,le.'Pa!al-,0 ,le.'
Gall'-%ne'Gall'-%ne'
-
7/23/2019 A. Obstruksi Usus
7/20
ELDERL;ELDERL;
I)pa0-e $ae0e' #ke!a'(I)pa0-e $ae0e' #ke!a'(
S-!ang.la-e "e!n,aS-!ang.la-e "e!n,a
Ca/ 0%l%nCa/ 0%l%n
6%l7.l.' #-&,'-,ng ,ge'-,7e -!a0-(6%l7.l.' #-&,'-,ng ,ge'-,7e -!a0-(
Pa!al-,0 ,le.'Pa!al-,0 ,le.'
-
7/23/2019 A. Obstruksi Usus
8/20
PATHOISOLOGIPATHOISOLOGI
P!%=,)al a!, "alangan #Deka-(P!%=,)al a!, "alangan #Deka-(1/1/ G.- ke)5%ng 0e0a,! )akanan anG.- ke)5%ng 0e0a,! )akanan an
.a!a.a!a
2/2/ K%n-!ak', 5e!le5,"anK%n-!ak', 5e!le5,"an3/3/ Re7e!'e pe!,'-al','Re7e!'e pe!,'-al','
4/4/ Reg.!g,-a',Reg.!g,-a',
>/>/ K.!ang pene!apan gangg.an 0e0a,!K.!ang pene!apan gangg.an 0e0a,!
anan ele0-!%l,-eele0-!%l,-e
?/?/
D,",!a', an ",p%7%le),aD,",!a', an ",p%7%le),a
-
7/23/2019 A. Obstruksi Usus
9/20
D, -e)pa- "alanganD, -e)pa- "alangan
1/1/ Bekalan a!a" kek.!anganBekalan a!a" kek.!angan
2/2/ Nek!%','Nek!%','
3/3/ Ul'e! ).k%'aUl'e! ).k%'a
4/4/ Pe!$%!a',Pe!$%!a',
>/>/ Pe!,-%n,-,'Pe!,-%n,-,'
D,'-al a!, "alangan #Ja."(D,'-al a!, "alangan #Ja."(1. (onsti%ation
2. (irit)irit jika inco$%lete
-
7/23/2019 A. Obstruksi Usus
10/20
MANIESTASI KLINIKALMANIESTASI KLINIKAL
1/1/ Ka!,nalKa!,nal
Sak,- a5%)enSak,- a5%)en
M.al < M.n-a" #N 9 6(M.al < M.n-a" #N 9 6(
D,'-en', a5%)enD,'-en', a5%)en
C%n'-,pa', < 0,!,-5,!,-C%n'-,pa', < 0,!,-5,!,-
2/ Sak,- a5%)en2/ Sak,- a5%)en
T,5a-,5a k%l,k, < ,n-e!),--en-T,5a-,5a k%l,k, < ,n-e!),--en-
Se-e)pa- , pe!,.)5l,kalSe-e)pa- , pe!,.)5l,kal Ra,a-,ng ke 5elakangRa,a-,ng ke 5elakang
Be!-e!.'an 8 gang!eneBe!-e!.'an 8 gang!ene
-
7/23/2019 A. Obstruksi Usus
11/20
3/ M.n-a"3/ M.n-a"
Te!.k an ke!apTe!.k an ke!ap A&al "alangan a-a'A&al "alangan a-a'
Le&a- "alangan 5a&a"Le&a- "alangan 5a&a"
4/ D,'-en', a5%)en4/ D,'-en', a5%)en
K.!ang "alangan a-a'K.!ang "alangan a-a'
Na-a "alangan 5a&a"Na-a "alangan 5a&a"
-
7/23/2019 A. Obstruksi Usus
12/20
PEMERIKSAAN ISIKALPEMERIKSAAN ISIKAL
INSPEKSIINSPEKSI
D,'-en',D,'-en',
Pe!,'-al','Pe!,'-al','
He!n,al p!%-!.',%n'He!n,al p!%-!.',%n'
S.!g,0al '0a!'S.!g,0al '0a!'
AUSKALTASIAUSKALTASI
B%&el '%.n'B%&el '%.n' @@",pe!ak-,$
-
7/23/2019 A. Obstruksi Usus
13/20
PALPASIPALPASI
Ma'' 5e!5en-.k 'a.'age 8Ma'' 5e!5en-.k 'a.'age 8
,n-.''.'0ep-,%n,n-.''.'0ep-,%n
Seg)en- 5%&el 5e!ke)5%ng Seg)en- 5%&el 5e!ke)5%ng "alangan"alangan
0l%'el%%p/0l%'el%%p/
Ke-ene!aan ,!e0- < !e5%.nKe-ene!aan ,!e0- < !e5%.n
G.a!,ng 9 !,g,,- 8 pe!,-%n,-,'/G.a!,ng 9 !,g,,- 8 pe!,-%n,-,'/
PERKUSIPERKUSI
Pe!k.', -,)pan,k/Pe!k.', -,)pan,k/
PER RECTAL EAM/ #DIGITAL(PER RECTAL EAM/ #DIGITAL(
Mengenalpa'-, ,n-.''.'0ep-,%nMengenalpa'-, ,n-.''.'0ep-,%n
pel7,0 )a'' !e0-al 0a!0,n%)apel7,0 )a'' !e0-al 0a!0,n%)a
-
7/23/2019 A. Obstruksi Usus
14/20
IN6ESTIGASIIN6ESTIGASI
1/1/ Da!a"Da!a"
HBHB
TDCTDC
BUSEBUSE
GM/GM/
2/2/ RaRa
A5%)enA5%)en
CRCR
3/3/ ECGECG
4/4/ Ul-!a'%.nUl-!a'%.n
>/ C%)p.-e!,e>/ C%)p.-e!,e
T%)%g!ap" #CTT%)%g!ap" #CT
Skan(Skan(
-
7/23/2019 A. Obstruksi Usus
15/20
DIAGNOSA PERBEAANDIAGNOSA PERBEAAN
1/1/ A0/ C"%le0'-,-,'A0/ C"%le0'-,-,'
2/2/ A0/ Appen,0,-,'A0/ Appen,0,-,'3/3/ A0/ Pan0!ea-,-,'A0/ Pan0!ea-,-,'
4/4/ PGUPGU
-
7/23/2019 A. Obstruksi Usus
16/20
PENGENDALIANPENGENDALIAN
1/1/ K%n'e!7a-,$K%n'e!7a-,$
Kenal pa'-, p.n0a 'e5a5 ke+a,an/ Kenal pa'-, p.n0a 'e5a5 ke+a,an/
Aaka" ,'e5a5ka5 $ak-%! la,n Aaka" ,'e5a5ka5 $ak-%! la,n
'epe!-, "e!n,a -.)%! an 'e5aga,na/'epe!-, "e!n,a -.)%! an 'e5aga,na/
-
7/23/2019 A. Obstruksi Usus
17/20
PENGENDALIAN
2/2/
Ope!a-,7eOpe!a-,7e
N,l 5 )%.-"/N,l 5 )%.-"/
Rle' -.5e a'p,!a-,%nRle' -.5e a'p,!a-,%n
M%n,-%! 7,-al ',gnM%n,-%! 7,-al ',gn
I
-
7/23/2019 A. Obstruksi Usus
18/20
KOMPLIKASIKOMPLIKASI
B%le" )ena-angkan k%)pl,ka', 'e!,.'/B%le" )ena-angkan k%)pl,ka', 'e!,.'/
Apa5,la .'.' )enge)5ang ke.paaanApa5,la .'.' )enge)5ang ke.paaan.n-.k )ene!ap )akanan an 0e0a,!.n-.k )ene!ap )akanan an 0e0a,!5e!k.!ang/5e!k.!ang/
K.!ang pene!apan 0e0a,!K.!ang pene!apan 0e0a,!)en,)5.lkan ge+ala ).n-a" e",!a',)en,)5.lkan ge+ala ).n-a" e",!a',)a'ala" kegagalan g,n+al an ak",!na)a'ala" kegagalan g,n+al an ak",!na
!en+a-an/!en+a-an/ Pen.)5a-an .'.' 5%le"Pen.)5a-an .'.' 5%le")engak,5a-kan pengal,!an a!a")engak,5a-kan pengal,!an a!a"-e!"en-, an ak",!na ,n,ng .'.' )a-,-e!"en-, an ak",!na ,n,ng .'.' )a-,
-
7/23/2019 A. Obstruksi Usus
19/20
KOMPLIKASI
Paa ak",!na )engak,5a-kanPaa ak",!na )engak,5a-kan
pe!,-%n,-,' ,n$ek', 5e!lak.pe!,-%n,-,' ,n$ek', 5e!lak.
1/1/D,",!a',D,",!a',
2/2/Ren+a-anRen+a-an
3/3/Pe!$%!a',Pe!$%!a',4/4/Pe!,-%n,-,'Pe!,-%n,-,'
-
7/23/2019 A. Obstruksi Usus
20/20
TE*IM+ K+,I-