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Perforasi Usus Jeanne d’Arc Dyanchana 1310211076

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Perforasi Usus

Perforasi UsusJeanne dArc Dyanchana1310211076DefinisiPerforasi usus, adalah suatu kondisi medis yang ditandai dengan terbentuknya suatu lubang pada dinding usus halus atau usus besar, yang menyebabkan kebocoran isi usus kedalam rongga perut.Etiologinya banyakTrauma tajam abdomen seperti pada luka tusuk oleh pisau.

Trauma tumpul abdomen luka pukul

Obat-obatan seperti aspirin, non steroidal anti inflammatory drugs (NSAIDs), dan steroid.

Adanya penyakit sebelumnya Ulkus peptikum, apendisitis akut, divertikulitis akut

Infeksi bakteri Infeksi bakteri seperti demam tifoid bisa menyebabkan perforasi usus halus sekitar 5%.

Perforasi usus halus oleh keganasan intra abdominal.

ManifestasiSymptoms may include:Severe abdominal painChillsFeverNauseaVomiting

When peritonitis occurs, the abdomen feels very tender. Pain often worsens when the area is touched or palpated

DiagnosisTo diagnose GP, your healthcare provider will likely:

take X-rays of your chest or abdomen to check for air in the abdominal cavitytake a CT scanto look for the location of the holeorder a test for a white blood cell count (WBC). WBC may be higher than usual indicating inflammation or infection

TreatmentAntibiotics have proven effective in decreasing the rate of postoperative wound infection and in improving outcome in patients with intraperitoneal infection and septicemia.

Metronidazole (Flagyl) is typically used in combination with an aminoglycoside to provide broad gram-negative and anaerobic coverage.Dosis: Adult dosing is 7.5 mg/kg IV before surgery. : Pediatric dosing is 15-30 mg/kg/d IV Cefoperazone sodium (Cefobid) is a third-generation cephalosporin that inhibits bacterial cell wall synthesis by binding to 1 or more of the penicillin-binding proteinsDosis: Adult dosing is 2-4 g/d IV divided q12h. : Pediatric dosing is 100-150 mg/kg/d IVTreatmentIn most cases, surgery is necessary to close the hole and treat the condition. According to Medscape (MS), the goals of surgery are:to fix the anatomical problemto fix the cause of peritonitisto remove any foreign material in the abdominal cavity that might cause problems, such as feces, bile, food, etc.

PrognosisThe success of the surgery depends on the size of the perforation or hole and the length of time before treatment. The chances of recovery improve with an early diagnosis and treatmentComplicationComplications associated with GP include:bleedingsepsis, a life-threatening bacterial infectionabscesses in the bellywound infection