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All Journal Medula JK Unila (Jurnal Kedokteran Universitas Lampung)
Aliezsa Esthi Kusuma
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Agriculture, Biological Sciences & Forestry Dentistry Education Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Sindrom Stevens-Johnson (SSJ) melebihi Nekrolisis Epidermal Toksik (NET) pada Geriatri: Laporan kasus Aliezsa Esthi Kusuma; Dwi Indria Angraini
Medula Vol 10 No 2 (2020): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v10i2.82

Abstract

Steven Johnson Syndrome (SSJ) is an acute, life-threatening disease characterized by necrosis and epidermal release in vesicobulosa skin, mucous orifice, and eyes, with severe general symptoms. The incidence of SSJ overlapping Toxic Epidermal Necrolysis (NET) is 1-10 cases per 1 million cases per year. The most common cause is hypersensitivity reactions to drugs. Pathogenesis of SSJ and NET is still not widely known. Symptoms begin with symptoms of prodromal flu like symptoms followed by bullae and epidermolysis. SSJ and NET based on age have been reported not only as risk factors but also associated with increased mortality. A 66-year-old woman presents with rashes, blisters and blisters accompanied by peeling all over her body including the skin, eyes, lips and genitals. Six days before hospital admission the patient had a history of treatment at a first-level health facility in the form of ondansentron, paracetamol, dexamethasone, chlorpheniramine, glyceryl guaiacolate, salbutamol, antacids and ranitidine. On physical examination found about 27% epidermiolisis body with positive sign Nicolsky. SCORTEN calculated on patient 3. Pharmacological treatment given to patients in the form of intravenous and topical antibiotics and steroids.
Reseksi Anastomosis Uretero-ureteral Pada Pasien Striktur Total Ureter Proksimal : Laporan Kasus Exsa Hadibrata; Mars Dwi Tjahyo; Angga Hendro Priyono; Aliezsa Esthi Kusuma; Muhammad Rifath Akbar; Tasya Khalis Ilmiani
Jurnal Kedokteran Universitas Lampung Vol 3, No 2 (2019): JK Unila
Publisher : Fakultas Kedokteran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23960/jk unila.v3i2.2499

Abstract

Striktur ureter merupakan penyempitan lumen ureter yang terjadi secara kongenital atau didapat. Striktur ureter dapat menyebabkan obstruksi sehingga terjadi penurunan fungsi ginjal secara cepat. Telah dilaporkan sebuah kasus seorang wanita berusia 21 tahun dengan riwayat buang air kecil (BAK) keluar batu (passing stone)  1 tahun yang lalu datang dengan keluhan nyeri pinggang kanan sejak ± 1 minggu SMRS. Keluhan tersebut dirasakan hilang timbul, disertai dengan demam. Pada pemeriksaan fisik tanda vital ditemukan peningkatan temperature 38,50C, status lokalis didapatkan nyeri tekan abdomen RUQ, regio flank didapatkan ballottementpositif pada palpasi, dan nyeri ketok CVA positif. Pada pasien ini dilakukan pemeriksaan penunjang darah lengkap dan didapatkan kesan leukositosis (15.150/μL), dan kesan USG ginjal adalah pyohidronefrosis berat. Kemudian dilakukan tindakan nefrostomi kanan serta pemeriksaan radiografi antegrade pyelography (APG) dan retrograde pyelography (RPG). Hasil radiografi menunjukkan terdapat striktur total pada ureter proksimal kanan dengan ukuran 2 cm. Pasien didiagnosis striktur total ureter proksimal kanan, kemudian dilakukan tindakan definitif berupa reseksi anastomosis uretero-ureteralserta insersi Double J (DJ) stent kanan. Tiga bulan pasca operasi, dilakukan tindakan pelepasan DJ stent kemudian dievaluasi dengan menggunakan RPG dan Ureteroscopy . Hasil RPG menunjukkan tidak tampak adanya striktur ureter kanan, pasase kontras lancar sampai ke ginjal. Dan hasil ureteroscopy menunjukkan ureter intak. Sehingga dapat disimpulkan, tindakan reseksi anatomosis ureter pada striktur ureter total proksimal dengan ukuran 2-3 cm memiliki outcome yang baik. Kata Kunci : Striktur ureter, uretero-ureteral anastomosis
Co-Authors Angga Hendro Priyono Dwi Indria Angraini Exsa Hadibrata Mars Dwi Tjahyo Muhammad Rifath Akbar Tasya Khalis Ilmiani