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ILEUS OBSTRUKSI

OLEH:

MUH. ISMAIL (110 207 0031)

UTARI MEDIAWATI (110 208 0062)

ASMA MUFIDA ALHADAR (110 209 0019)

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IDENTITAS PASIEN

N. R!"#$M!%&" : '866

N#$#P#*&!+ : T+. H. K

U$,- : '2 #/,+

!+&* K!#$&+ :L#""&

A#$# : K!. KALIBOBO PAPUA

T#+# #/&- : 03 N!$4!- 1962

A#$# : I*#$

K!4#+*##+ :I+%+!*

T P!-&"*# : 10 F!4-,#-5 201'

P!-###+ B#+ : L+#-# 2 A#* D!#+ ( B!%#/ D&!*&!) K#$#- 1

B!% 1 RS. W#/&%&+ S,%&-/,*%

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ANAMNESISK!,/#+ ,#$# : N5!-& !-, "#+#+ 4##/

D#$& *!#" 2 /#-& *!4!,$ $#*," -,$#/ *#"&.N5!-& %&-#*#"#+ 4!-* /+ &$4,. A#+5##*&!+ $!-#*#"#+ +5!-& %& 4#+ ,, /#& "!$,%+

$!+##- "! !-, "#+#+ 4##/. P#*&!+ ,#$!-#*#"#+ !-,+5# "!$4,+; 4,#+ #&- 4!*#- %#+4,#+ #* !-#"/&- *!#" 1 /#-& 5#+ #,.

R# %!$#$ #%#; $,# #%#; %#+ $,+#/ #%#

*!#" %,# /#-& 5#+ #,. R# BAB *!!-&"-#+ "#$4&+ %#+ BAB 4!-

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PEMERIKSAAN FISISK!#%##+ ,$,$ : S#"& *!%#+

K!*#%#-#+ : =$* $!+&*

S#,* >&?& : >&?& 4#&"

T#+%# @

T!"#+#+ %#-#/ : 11070 $$H

N#%& : 88 "#&$!+&

P!-+##*#+ : 20 "#&$!+&

S,/, : 37=

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Mata

K!#" $## : E%!$# ()

K+,+ : A+!$ ()S

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Leher

K>B : T&%#" #%# !$4!*#-#+

Dada

I+*!"*&B!+," : S&$!-&*

S!# I# : D##$ 4##* +-$#

Paru paru

P##*&

N5!-& !"#+: ()

P!-",*&

P#-, "&-& : S+-

P#-, "#+#+ : S+-

A,*",#*&

B,+5& P!-+##*#+: @!*&",!-

B,+5& #$4#/#+: ()

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Jantung

I+*!"*& : I",* "-%&* &%#" #$#" !$4!*#-#+

P##*& : I",* "-%&* &%#" !-#4#

P!-",*& : P!"#"

A,*",#*&

B,+5& #+,+ : B,+5& #+,+ III $,-+& -!,#-

B,+5& #$4#/#+ : B&*&+ ()

Abdomen

I+*!"*& : T#$#"

P##*& : N5!-& !"#+ (); $#**# ,$- ()

P!-",*& : T&$#+&

A,*",#*&: P!-&*#&" () "!*#+ M!+,-,+

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R!

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LABORATORIUMJenis Pemeriksaan Hasil Nilai rujukan Unit

Darah

Rutin

WBC 9,7 4.00 10.0 10 /uL

RBC 4,86 4.50 6.50 10 /uL

HGB 15,4 14.0 18.0 g/dL

HCT 43,6 40.0 54.0 %

PLT 249 150 400 10 /uL

injal

Hiperte

nsi

Ureu 62 10!50 g/d"

#re$&'&' 1,10 (1,3 g/d"

!imia

Hati

)G*T 17 (38 u/L

)GPT 34 (41 u/L

"lektrol

it

+$r&u 134 136 145 "/

L

#$"&u 3,8 3,5 5,1 "/

L

C"r&d$ 97 97 111 "/

L

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RADIOLO>IFOTO ABDOMEN 3 POSISI

U%#-# ,*,* &%#"!-%&*-&4,*& *#$#& "!%&*#

T#$#" #$4#-#+ %#*& ,*,*; #$4#-#+/!--&+ 4+! %#+ #&- C,&%!! 5#+ 4!-&+"#&+"# $!$4!-&"#+#$4#-#+ *! #%%!-

T&%#" #$#" #$4#-#+,%#-# 4!4#* *,4%-#$#

K!%,# *#* &+! &%#"!-&*,#&*#*&

K!%,# -!!-&+!# # &+!&+#"

K!*#+ : I!,* O4*-,"*&

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TERAPII@FD RL 2 $

=!-+! 1 -12 #$ &

R#+&&%&+! 1 #$8#$&

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TINAUAN PUSTAKA

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ANATOMI

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DEFINISI ILEUS OBTRUKSIO4*-,"*& ,*,* #%##/ #+,#+ (##,+

!+5!4#4+5#) #&-#+ +-$# &*& ,*,* *!#+#+*#,-#+ ,*,*; 5#+ %## 4!-* #",; $#,,+"-+&*; #-* $#,,+ #. S!4#+ 4!*#-

4*-,"*& $!+!+#& ,*,* /#,*. T!-%## %,#!+&* 4*-,"*& ,*,* 5#&, ) $!"#+&* (I!,*4*-,"&) %#+ ++$!"#+&* ($&*. I!,* #-#&&"##, &!,* #%&+#$&".

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ETIOLO>IFAKTOR INTRINSIK

=-/+ %&*!#*!

P!+5!4#4 N!#*&" N!#* (#-#+)

R#%*& E+!-&&*H!$#$#*

@#*",#- O",*&

H!-+

FAKTOR I+-#,$&+#B#, E$!%, I!,*

S&%-$ O4*-,"*& D&*# U*,*

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>EALA KLINIS>!## "#-%&+# 4-,"*& ,*,* /#,* #%##/

!-!#+#+ #4%$!+; +5!-&; $,+#/; %#+"+**& #4*,. N5!-& 4*#+5# $!+5!-,#&"!#+ %&!-!+#/#+ #4%$!+ (!-,#$#

%&%#!-#/ #-#,$4&&"#&*) %#+ $!$4!-# 4!#" 4*-,"*& $#"&+ &+&. A4%$!+ %##!-#*# +5!-&. F-!",!+*& $,+#/ 4!-#-*&4!-#+,+ #%# !#" 4*-,"*&. K+**&

#4*, *!-&+ !-#%& %&+& #%# ,*,* 4!*#-; !#&C#,* %#+ !*!* $,+"&+ %## %&"!,#-"#+ #%#!-$,##+ 4*-,"*& ,*,* /#,*.

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DIA>NOSISD+*&* P#%# 4*-,"*& ,*,* /#,* %##

%&!#""#+ ##* %#*#- "&+&" %!+#+ #+#$+!*&*;!$!-&"*##+ G*&"; !$!-&"*##+ R#%&&; %#+!$!-&"*##+ #4-#-&,$.

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>AMBARAN RADIOLO>I ILEUSOBTRUKSI

G$-$r 1. ,%, P,",/ 0-d,e'. T$$ e"$/ d&"$%$/& loop u/u/

$"u/ $'g e-er&$' g$-$r$' air-fluid level $d$ ,/&/& %eg$

$7 d$' herring bone /e-$g$& e%$'d$ &"eu/ ,-/%ru%& $d$ ,/&/&

/u&'e -7.

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G$-$r 2. ,%, P,",/ 0-d,e' P,/&/&

9re:% e'u'u$' air-fluid levels $'g

u"%&e" d& d$"$ ",,!",, u/u/ $"u/

$'g d&"$%$/&

G$-$r 3. ,%, P,",/ 0-d,e' ,/&/& ere:%

e'u'u$' %$'d$ ;string of beads< $'g

eru$$' %$'d$ d&$g',/%& ,-/%ru/& u/u/

$"u/.

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G$-$r 4 ="eu/ *-/%ru%& ,%,

U)G>&'d&'g u/u/ e'e-$" de'g$' ,"$

-er%&'g$% e:, $'$7 d$' $/:&%e/ 07

G$-$r 5 CT /:$' $?&$" d$r& ,-/%ru/&

u/u/ CT /:$' $?&$" e'u'u$'

$d$'$ :$&r$' d$' d&"$%$/& loop u/u/

e:&" $'$ u%& 7 d$' ru'%u u/u/

$'$ er$ 7 ,'/&/%e' de'g$',-/%ru/& u/u/ e:&" e$'&.7

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PENATALAKSANAAND#*#- !+4##+ 4*-,"*& ,*,* #%##/ "-!"*&

"!*!$&$4#+#+ !!"-& %#+

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DIA>NOSIS BANDIN>ILEUS PARALITIK

I!,* #-#&&" #%##/ "!#%##+ %&$#+# ,*,*##&%#" $#$, $!#","#+ "+-#"*& !-&*#&" ,+,"$!+5#,-"#+ &*&+5#.

P#*&!+ &!,* #-#&&" #"#+ $!+!,/ !-,+5#"!$4,/ (4%$&+# %&*!+*&+) #+-!"* $,#; %#+**&. M,+#/ $,+"&+ #%#; M,+"&+ ,# &%#" #%#.K!,/#+ !-, "!$4,+ #%# &!,* #-#&&" &+& !-,

%&4!%#"#+ %!+#+ "!,/#+ !-, "!$4,+ #%# &!,*4*-,"*&. P#*&!+ &!,* #-#&" $!$,+5#& "!,/#+ !-,"!$4,+; &%#" %&*!-#& +5!-& "&" #4%$!+ 5#+#-"*&$#.

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>AMBARAN RADIOLO>I

G$-$r 4. ="eu/ $r$"&%& ,%, /u&'e.

0d$ d&"$%$/& ge'er$"&/$%$ $d$ u/u/

$"u/ d$' u/u/ -e/$r. W$'&%$ 84 %$u'

de'g$' er&%,'&%&/ ge'er$"&/$%$ d$'

er,r$/& $re'$ u"u/ g$/%er.

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G$-$r 6. ,%, B+* ,/&/& supine d$' left lateral

decubitus. T$$ d&"$%$/& loop-loop u/u/ e'u'u$'

g$-$r$' &"eu/ $r$"&%&.

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DISKUSI

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B!-%#*#-"#+ *#,* #*&!+ T+. H K %!+#+ %+*&*I!,* O4*-,"*& %!+#+ "!,/#+ +5!-& !-, "#+#+ 4##/%#$& *!#" 2 /#-& *!4!,$ $#*," -,$#/ *#"&. N5!-&%&-#*#"#+ 4!-* /+ &$4,. A#+5# #*&!+$!-#*#"#+ +5!-& %& 4#+ ,, /#& "!$,%+ $!+##- "!!-, "#+#+ 4##/. P#*&!+ ,# $!-#*#"#+ !-,+5#

"!$4,+; 4,#+ #&- 4!*#- %#+ 4,#+ #* !-#"/&- *!#" 1/#-& 5#+ #,. R# %!$#$ #%#; $,# #%#; %#+ $,+#/#%# *!#" %,# /#-& 5#+ #,. R# BAB *!!-& "-#+"#$4&+ %#+ BAB 4!-

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P!$!-&"*##+ -#%&& #4%$!+ 3 *&*&%&!$,"#+ #$4#-#+ I!,* O4*,-"*& (Small bowelobstruction

) %!+#+ #$4#-#+ *!4##& 4!-&", :

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S!/&+# B!-%#*#-"#+ /#*& #+#$+!*&*;!$!-&"*##+ G*&" %#+ -#%&& #%# #*&!+ &+&%## %&*&$,"#+ 4#/# #*&!+ $!+%!- &!,*4*-,"*&. P!+4##+ #%# #*&!+ &+& %!4!-&"#+;

I@FD RL 2 $;

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DAFTAR PUSTAKAM#-&+

W!*!-+ ,-+# E$!-!+=J 2007./.1.

S A+# =##-&+# ! #. S$# B! O4*-,

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SH K&$; KN P#-"; S K&$; =K E,+; M P#-"; MK O/; KH =/&; H K&$; DW K&$;

H =/; H =/; H O/; H P#-" ANORED IN THE ELDERL: H+"+; P 1.

M,#+; =/#-!* P. ! #. S$# B! O4*-,

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TERIMA KASIH