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Duplikasi Lambung Yang Dikelola Dengan Mucosektomi Dan Perbaikan Lambung: Laporan Kasus Yang Langka Aslam, Filza RA; Ismar , Ibrahim; Wahid, Tubagus OR; Valentino, Andrea; Salamullah, Salamullah; Sabrina, Viona
Journal of Medicine and Health Vol 7 No 2 (2025)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.28932/jmh.v7i2.11079

This case report aims to present the clinical presentation, diagnostic workup, surgical management, and outcome of a rare case of gastric duplication in an infant. Gastrointestinal duplication (GD) is a rare congenital anomaly accounting for 4–8% of all duplication cases, predominantly occurring in children. An 8-month-old female presented with a progressively enlarging abdominal mass, vomiting, and distension. Initial ultrasound months earlier showed a mass near the umbilicus, but the family pursued alternative treatments. Examination revealed a well-defined, rubbery cystic mass (8 × 5 cm). Sonography showed a septated cystic lesion, and a barium study demonstrated a filling defect. The patient underwent exploratory surgery with mucosectomy and gastric repair. Postoperatively, she received intravenous fluids, antibiotics, analgesics, and proton pump inhibitors. Despite transient vomiting and distension, by day seven, she gained weight and was discharged. Histopathology confirmed a benign gastric duplication cyst. At 11-day follow-up, she was thriving and feeding well. This case underscores the importance of early diagnosis and surgical intervention in GD to prevent complications and highlights favorable outcomes with timely management.

Functional Limb Salvage Following a 24-Hour-Delayed Fasciotomy for Pediatric Hand Compartment Syndrome: A Case Report Rohman Sungkono; Adri Yandra Hidayat; Andrea Valentino; Ade Wirdayanto; Arip Heru Tripana
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i12.1458

Background: Acute compartment syndrome (ACS) in the pediatric hand is a formidable surgical emergency where delayed diagnosis can lead to devastating neuromuscular deficits and limb loss. The narrow therapeutic window, often termed the "golden hours," is considered critical for preventing irreversible ischemic necrosis. Presentations delayed beyond this period, especially in pre-verbal children, pose a significant clinical and ethical dilemma regarding the utility and risks of surgical intervention. Case presentation: A 2-year-old female presented to our emergency department 24 hours after a severe crush injury to her right hand from a noodle-making machine. The hand was massively swollen, cyanotic, and insensate, with no detectable capillary refill or digital oximetry readings. A clinical diagnosis of advanced, multi-compartmental ACS was made. Emergency surgical decompression was performed via seven incisions, releasing all ten osteofascial compartments. Intraoperative assessment revealed dusky, non-contractile but bleeding muscle. Following staged debridements, the patient demonstrated remarkable recovery. At six months, she achieved full range of motion in all digits except the middle finger and demonstrated age-appropriate grip and pincer grasp, with the primary sequela being a fixed flexion contracture of the middle finger's proximal interphalangeal joint. Conclusion: This report highlights a case of unexpected functional recovery following a significantly delayed fasciotomy. The outcome supports a nuanced approach to delayed pediatric ACS, suggesting that in select cases, aggressive surgical decompression should be considered as the potential for a positive outcome may exist. This case serves as a powerful, hypothesis-generating observation that raises critical questions about the absolute temporal limits for surgical intervention and underscores the importance of individualized surgical judgment.

Functional Limb Salvage Following a 24-Hour-Delayed Fasciotomy for Pediatric Hand Compartment Syndrome: A Case Report Rohman Sungkono; Adri Yandra Hidayat; Andrea Valentino; Ade Wirdayanto; Arip Heru Tripana
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i12.1458

Background: Acute compartment syndrome (ACS) in the pediatric hand is a formidable surgical emergency where delayed diagnosis can lead to devastating neuromuscular deficits and limb loss. The narrow therapeutic window, often termed the "golden hours," is considered critical for preventing irreversible ischemic necrosis. Presentations delayed beyond this period, especially in pre-verbal children, pose a significant clinical and ethical dilemma regarding the utility and risks of surgical intervention. Case presentation: A 2-year-old female presented to our emergency department 24 hours after a severe crush injury to her right hand from a noodle-making machine. The hand was massively swollen, cyanotic, and insensate, with no detectable capillary refill or digital oximetry readings. A clinical diagnosis of advanced, multi-compartmental ACS was made. Emergency surgical decompression was performed via seven incisions, releasing all ten osteofascial compartments. Intraoperative assessment revealed dusky, non-contractile but bleeding muscle. Following staged debridements, the patient demonstrated remarkable recovery. At six months, she achieved full range of motion in all digits except the middle finger and demonstrated age-appropriate grip and pincer grasp, with the primary sequela being a fixed flexion contracture of the middle finger's proximal interphalangeal joint. Conclusion: This report highlights a case of unexpected functional recovery following a significantly delayed fasciotomy. The outcome supports a nuanced approach to delayed pediatric ACS, suggesting that in select cases, aggressive surgical decompression should be considered as the potential for a positive outcome may exist. This case serves as a powerful, hypothesis-generating observation that raises critical questions about the absolute temporal limits for surgical intervention and underscores the importance of individualized surgical judgment.

Hyponatremia After Intracranial Hemorrhage: Cerebral Salt Wasting Syndrome (CSWS) or The Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH)? Wan Novriza Wijaya; Novita Anggraeni; Sony; Andrea Valentino
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i1.1174

Background: Hyponatremia is a common electrolyte disorder encountered in neurosurgical patients, often associated with significant morbidity and mortality. This case report highlights the importance of recognizing and appropriately managing cerebral salt wasting syndrome (CSWS), a rare but important cause of hyponatremia in neurosurgical patients, often following intracranial hemorrhage (ICH). Distinguishing CSWS from the syndrome of inappropriate antidiuretic hormone secretion (SIADH) is crucial for appropriate management. Case presentation: A 56-year-old male with a history of hypertension and diabetes mellitus presented with sudden-onset left-sided weakness and decreased consciousness following an ICH. He underwent a ventriculoperitoneal (VP) shunt placement for hydrocephalus. Post-operatively, he developed hyponatremia with elevated urine sodium levels and hypovolemia, suggestive of CSWS. The patient was treated with fluid replacement therapy, including hypertonic saline, and desmopressin, resulting in improvement in his hyponatremia. Conclusion: CSWS is an important cause of hyponatremia in neurosurgical patients. Prompt diagnosis and appropriate management, including fluid replacement and potentially desmopressin, can improve patient outcomes. This case underscores the need for a high index of suspicion for CSWS in neurosurgical patients presenting with hyponatremia and highlights the importance of careful monitoring and individualized treatment strategies.

Effects of Propofol and Thiopental on Brain Relaxation and Hemodynamic Response to Craniotomy Supratentorial Tumors Removal Valentino, Andrea; Wijaya, Wan Novriza; Anggraeni, Novita; Sony, Sony
Majalah Kedokteran Bandung Vol 57, No 4 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v57.4283

Surgical procedures for brain tumors, particularly supratentorial tumor removal via craniotomy, present challenges related to brain relaxation and maintaining hemodynamic stability. The choice of intravenous anesthetics, such as Propofol and Thiopental, is crucial due to their distinct effects on intracranial pressure (ICP), cerebral blood flow (CBF), and hemodynamic parameters. This study aimed to compare the effects of Propofol and Thiopental on brain relaxation and hemodynamic responses during supratentorial tumor removal. A randomized experimental study was conducted at Arifin Achmad General Hospital, Riau, Indonesia, from May to September 2024 involving patients undergoing elective craniotomy for supratentorial tumors. Patients were divided into two groups: the Propofol group (1-3 mg/kg body weight, with maintenance of 50-100 µg/kg/min) and the Thiopental group (4-6 mg/kg body weight, with maintenance of 100-200 µg/kg/min), both receiving continuous infusion until a bispectral index of 40-60 was achieved. Hemodynamic parameters, including systolic blood pressure, diastolic blood pressure, mean arterial pressure (MAP), and heart rate, were measured at various stages: before induction, during surgery, and at multiple intervals. Brain relaxation was subjectively assessed by a neurosurgeon using a four-point scale. Results showed that 90% of subjects receiving Thiopental experienced good brain relaxation during duramater opening, compared to 70% in the Propofol group, though this difference was not statistically significant (p=0.118). Hemodynamically, the Thiopental group exhibited higher diastolic blood pressure and MAP at induction (p<0.05). In conclusion, Thiopental demonstrated superior hemodynamic stability, albeit both agents provided equally effective brain relaxation.

Eventrasi Diafragma Kanan: Strategi Operasi dan Hasil Klinis Aslam, Filza R A; Ismar, Ibrahim; Wahid, Tubagus O R; Valentino, Andrea; Salamullah, Salamullah; Sabrina, Viona
Journal of Medicine and Health Vol 8 No 1 (2026)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.28932/jmh.v8i1.11115

Eventrasi diafragma kongenital merupakan kelainan bawaan yang jarang terjadi, akibat kegagalan perkembangan otot diafragma, dengan data insidensi dan prevalensi terbatas. Eventrasi diafragma kongenital kanan lebih jarang terjadi, dengan insidensi sekitar 1 dari 10.000 kelahiran hidup, dan dapat menjadi kegawatan pada neonatus karena menimbulkan distres pernapasan berat. Tujuan penulisan ini adalah untuk melaporkan kasus serta menyoroti pentingnya diagnosis serta penatalaksanaan dini pada kasus eventrasi diafragma kongenital kanan. Kami melaporkan kasus bayi perempuan usia tiga hari dengan sesak napas sejak lahir, asimetri gerakan dinding dada, suara napas menurun pada hemitoraks kanan, serta suara usus di rongga toraks. Babygram menunjukkan elevasi hemidiafragma kanan dengan loop usus intratorakal. Pasien menjalani laparotomi eksplorasi emergensi dengan plikasi diafragma, dan pascaoperasi terjadi perbaikan fungsi pernapasan sehingga dapat dipulangkan dalam kondisi baik. Kasus ini menegaskan peran penting deteksi dini dan intervensi pembedahan segera dalam memperbaiki luaran pada neonatus dengan eventrasi diafragma kongenital kanan.

A Rare Presentation of Hemothorax due to Left Hemithorax Penetrative Wound: An Operative Approach Requiring Segmentectomy Endrika, Adhia; Deviandri, Romy; Wirdayanto, Ade; Hendra, Fakhrul; Briliant, Briliant; Valentino, Andrea
Journal of Medicine and Health Vol 8 No 1 (2026)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.28932/jmh.v8i1.11791

Hemothorax is a medical emergency as blood accumulates inside the pleural space due to spontaneous, iatrogenic, or traumatic etiology. In general, hemothorax has a good prognosis. But severe hemothorax, especially those in vital areas, can lead to more invasive management. This case report aims to explore the presentation of massive hemothorax due to penetrative trauma and discuss suitable management approaches. A 16-year-old patient came due to spear wound through the left shoulder without exit wound. From primary assessment we found subcutaneous emphysema in the left lung, without compensation in airway and circulation system. A thoracocentesis intervention promptly performed as initial treatment. Secondary management proceeded with surgical thoracotomy which resulted in segmentectomy. Around 2-6% of patients of hemothorax patients need surgical intervention, and less than 2% will need segmentectomy intervention due to bleeding that cannot be corrected with surgical ligation. This case is one of the rare cases of hemothorax with segmentectomy. Although this patient did not have any respiratory nor circulatory complication, laceration in proximal hilum area leads to massive bleeding that damaged the lung parenchyma. Vigilant assessment in patients with penetrative trauma, especially in the left hemithorax, is essential to diagnose possible complication and execute evidence-based management plan.

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