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All Journal Syntax Literate: Jurnal Ilmiah Indonesia Cermin Dunia Kedokteran
Tambun, Renaningtyas
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A Multimodal Approach to the Management of Diverticular Abscess with Paraesophageal Hernia Complication Pauliana, Pauliana; Koncoro, Hendra; Prawidiyanto, Albertus Ardian; Gora, Cosmas; Irman, Irman; Tambun, Renaningtyas
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v9i10.16411

Abstract

This study aims to evaluate the management of acute diverticulitis complicated by hernia and the role of electroacupuncture in managing postoperative ileus. The case involved a 51-year-old male patient who presented with left lower abdominal pain, fever, and defecation disorder. Physical examination showed signs of infection with localized peritonitis, while laboratory tests revealed neutrophilia. CT scan showed diverticulitis with abscesses in the descending and sigmoid colon, as well as free air around the colon and perihepatic region, and paraesophageal hernia. The patient underwent left hemicolectomy with Hartmann's procedure. Postoperatively, the patient developed ileus which was treated using electroacupuncture. The results showed that the relationship between diverticulosis and hernia is due to connective tissue changes. Approximately 10-20% of diverticulosis cases progress to acute diverticulitis. CT scan is the gold standard for diagnosis, staging and management of diverticulitis. In cases of Hinchey III diverticulitis, laparoscopic washing does not give better results compared to colonic resection. The Hartmann procedure is recommended for patients with multiple comorbidities. Electroacupuncture proved to be an effective adjunctive therapy in managing postoperative ileus. The conclusion of this study is that a multimodal approach, including surgery and complementary therapies such as electroacupuncture, is essential in the management of diverticulitis and its complications. The implication of this study is the need for a holistic approach in managing patients with acute diverticulitis, especially in cases with multiple comorbidities and risk of postoperative complications.
Primary Intraosseous Carcinoma, Not Otherwise Specified with Ameloblastic Carcinoma Features in a Middle-aged Woman Candinegara, Stephen Utama; Gede Subawa, Dewa; Tambun, Renaningtyas
Cermin Dunia Kedokteran Vol 49 No 9 (2022): Neurologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v49i9.297

Abstract

Primary Intraosseous Carcinoma, Not Otherwise Specified (PIOC, NOS) is an extremely rare neoplasm defined as squamous cell carcinoma in the mandible, presumably from the residue of odontogenic epithelium. The diagnosis is often challenging, and the prognosis is poor. The treatment of choice is surgical excision but usually declined for cosmetic reasons. A 41-year-old Melanesian woman with a mass in her right jaw since two years ago but rapidly growing in the last six months, accompanied with pain. Irregular hard mass was found in the right mandible. Radiology studies revealed lytic tumors, likely infiltrating. No metastasis was found. The first biopsy revealed acanthomatous ameloblastoma, and the second biopsy revealed pseudoepitheliomatous hyperplasia. Wide excision was then conducted with pathology results of PIOC and NOS with some features of ameloblastic carcinoma. This case may arise from a previous benign precursor. Further genetic information may be needed. The treatment of choice is surgical excision. The prognosis needs further follow-up.   Primary intraosseous carcinoma, not otherwise specified (PIOC, NOS) merupakan keganasan odontogenik yang langka. Diagnosisnya sulit dengan prognosis buruk. Tata laksana utama adalah bedah eksisi yang cenderung ditolak karena alasan estetik. Seorang perempuan ras Melanesia usia 41 tahun, mengeluh benjolan rahang kanan sejak dua tahun dan makin membesar terutama 6 bulan terakhir disertai nyeri. Massa tidak teratur dengan batas tidak jelas di mandibula kanan dengan ukuran 10 x 8 x 4 cm. Pemeriksaan radiologis menegaskan massa infiltratif, tetapi tidak menemukan anak sebar. Biopsi awal menunjukkan ameloblastoma, biopsi selanjutnya menunjukkan pseudoepitheliomatous hyperplasia. Eksisi luas dilakukan dan patologi menemukan PIOC, NOS dengan sebagian ciri ameloblastic carcinoma. Patologi dari tiga biopsi menunjukkan massa jinak odontogenik yang mengalami inflamasi kronis kemudian menjadi ganas. Prognosis masih belum bisa dipastikan.
Co-Authors Candinegara, Stephen Utama Gede Subawa, Dewa Gora, Cosmas Hendra Koncoro Irman Irman Pauliana, Pauliana Prawidiyanto, Albertus Ardian Setijoso, Rafael Eddy