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Peranan Ultrasonografi dalam Diagnosis Trauma Testis Rizqi, Putri; Erawati, Dini; Satyagraha, Paksi
Jurnal Klinik dan Riset Kesehatan Vol 1 No 2 (2022): Edisi Februari
Publisher : RSUD Dr. Saiful Anwar Province of East Java

External genitalia trauma is more common in men than women, especially in the age range of 15 & 40 years. This is due to the anatomical differences and the increase in the frequency of traffic accidents. The number of external genitalia trauma ranged from 33–66% of all urological cases. External genitalia trauma is most often caused by blunt trauma, one of which is testicular rupture. Testicular rupture refers to a tear in the tunica albuginea resulting in extrusion of testicular contents. Determining the appropriate examination procedure requires adequate physical examination and information about the mechanism of trauma to allow a good prognosis. Scrotal ultrasound (SUS) is the first choice of modality in the case of testicular injury with sensitivity in detecting testicular rupture up to 100%. In addition, the SUS examination procedure can be carried out immediately, non-radiatively, and non-invasively. The main ultrasound findings for testicular rupture include testicular heterogeneity, contour abnormalities, and a tear in the tunica albuginea. These findings can be used to determine the degree of testicular injury according to the AAST (American Association for the Surgery of Trauma), which can then be used to determine the definitive treatment management. We present a case of a 19-year-old male patient complaining of pain on his left testicle since 16 hours before hospital admission after a traffic accident. Physical examination revealed a scrotal hematoma, and nausea and vomiting were found. Ultrasound examination indicated extensive tearing of the left testicular structure according to AAST grade IV with complex hydrocele.

Rare Case : Lymphangioleiomyomatosis in a 28 year-old woman with spontaneous bilateral pneumothorax Matabei, Shannon Conversia Pdabo; Djajalaksana, Susanthy; Chozin, Iin; Erawati, Dini; Wardhana, Koernia; Yudhanto, Hendy; Rahman, Perdana; Chen, Chung-Yu
Malang Respiratory Journal Vol. 7 No. 2 (2025): Volume 7 No 2, September 2025 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2025.007.02.04

Introduction: Lymphangioleiomyomatosis (LAM) is an extremely rare disease with no known exact cause, in which there are abnormalities in the development of smooth muscle cells. This condition manifests in multiple organs, one of which is the lungs. Prevalence of LAM is 1 in 1,000,000, most commonly found in women of reproductive age. Pneumothorax occurs in two-thirds of LAM patients. It is possibly underdiagnosed in Indonesia. Case report: A 28-year-old woman came to the Emergency Department with sudden severe shortness of breath. Chest X-ray shows bilateral pneumothorax predominantly on the left side, and a chest tube was installed. Thorax MSCT revealed multiple cysts in all areas of lungs, while abdominal USG and MRI discovered masses in uterus and right adrenal. Left bullectomy-thoracotomy and lung biopsy were performed, with histopathology result supporting LAM. The patient was stable post surgery. LAM is associated with mutations in TSC1 or TSC2 genes, resulting in cystic changes caused by LAM cells proliferation in the lungs. In this patient, bilateral pneumothorax resulted from multiple subpleural cysts which eventually ruptured. Diagnosis of LAM was established by radiological imaging and lung biopsy. Surgical and non-surgical interventions were performed to address the acute manifestations of LAM. Unfortunately, Sirolimus which is the recommended long-term medication for LAM is not yet available in Indonesia. Conclusion: LAM is a rare disease. It’s important for clinicians to be familiar with this condition, aware of its progression and possible recurrence of pneumothorax, in order to provide appropriate interventions.

Peranan Ultrasonografi dalam Diagnosis Trauma Testis Rizqi, Putri; Erawati, Dini; Satyagraha, Paksi
Jurnal Klinik dan Riset Kesehatan Vol 1 No 2 (2022): Edisi Februari
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.01.2.7

External genitalia trauma is more common in men than women, especially in the age range of 15 & 40 years. This is due to the anatomical differences and the increase in the frequency of traffic accidents. The number of external genitalia trauma ranged from 33–66% of all urological cases. External genitalia trauma is most often caused by blunt trauma, one of which is testicular rupture. Testicular rupture refers to a tear in the tunica albuginea resulting in extrusion of testicular contents. Determining the appropriate examination procedure requires adequate physical examination and information about the mechanism of trauma to allow a good prognosis. Scrotal ultrasound (SUS) is the first choice of modality in the case of testicular injury with sensitivity in detecting testicular rupture up to 100%. In addition, the SUS examination procedure can be carried out immediately, non-radiatively, and non-invasively. The main ultrasound findings for testicular rupture include testicular heterogeneity, contour abnormalities, and a tear in the tunica albuginea. These findings can be used to determine the degree of testicular injury according to the AAST (American Association for the Surgery of Trauma), which can then be used to determine the definitive treatment management. We present a case of a 19-year-old male patient complaining of pain on his left testicle since 16 hours before hospital admission after a traffic accident. Physical examination revealed a scrotal hematoma, and nausea and vomiting were found. Ultrasound examination indicated extensive tearing of the left testicular structure according to AAST grade IV with complex hydrocele.

A Confirmed Case of Idiopathic Pulmonary Fibrosis - Probable Usual Interstitial Pneumonia Pattern through Lung Biopsy Kristiani, Maria; Djajalaksana, Susanthy; Erawati, Dini; Yudhanto, Hendy; Bayuadi, Imam
Malang Respiratory Journal Vol. 4 No. 1 (2022): Vol. 4 No. 1
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2022.004.01.2

Background: Although classified as a rare disease, the global burden of disease study reports showed that interstitial lung disease is ranked 40th in the diseases with high mortality, and its prevalence had increased by 86% since 1990. The most common interstitial lung disease”idiopathic pulmonary fibrosis (IPF)”has low survival rates”2-3 years after diagnosis”and is irreversible. Establishing a definite diagnosis of IPF is very difficult because it needs a multidisciplinary approach, as an establishment based on the description of HRCT and lung biopsy is needed. The goal of therapy is to prevent the progression of fibrosis. Case: We report a case of an adult woman, 46 years old with idiopathic pulmonary fibrosis (IPF) with Probable Usual Interstitial Pneumonia (UIP) pattern at dr. Saiful Anwar Hospital. History taking, physical examination and laboratory and chest Xray examination of the patient found a suspicion of ILD. CT-scan showed fibrosis in both lungs, honeycomb appearance with pulmonary bronchiectasis traction, which fit the description of IPF, and thus suspended the diagnosis of ILD. VATS pulmonary biopsy confirmed the diagnosis of IPF. The patient experienced a decrease in clinical conditions, as her complaint was worsening in the last month, in accordance to the state of acute exacerbations. Conclusion: In this patient, the diagnosis of IPF with Probable UIP pattern was made through a multidisciplinary approach, including the pulmonology, radiology and anatomical pathology department. Keywords: IPF, IPF, Probable UIP Pattern, IPF Diagnosis

Lobectomy Procedure in Reccurent Hemoptysis and History of Tuberculosis Treatment with Suspected Lung Mycosis Kartikasari, Ulfah; Sugiri, Yani; Bayuadi, Imam; Erawati, Dini; Yudhanto, Hendy
Malang Respiratory Journal Vol. 4 No. 1 (2022): Vol. 4 No. 1
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2022.004.01.5

Background : Hemoptysis is one of the often symptoms that complained in respiratory disease with fungal Infection. Jakarta reported that prevalency of Invasive Pulmonary aspergillosis is 7,7% and Pneumocystis pneumonia is 14.5%. Lung mycosis is still difficult to diagnosed so the management of therapy is often too late. The risk factors of lung mycosis in these patient are immunocompromised conditions with Diabetes Melitus, history of Tuberculosis treatment and COPD. The diagnosis criteria of systemic/invasive mycosis are proven, probable and possible. Proven criteria diagnosed is based on host factor, clinical finding and mycology whereas possible criteria diagnosed is based on host factor and clinical finding without mycology.Case Report: We report one case at Dr. Saiful Anwar hospital, Man, 43 years old with History of Tuberculosis Treatment and suspected as Lung Mycosis with chef complained hemoptoe recurrent in last 2 months, shortness of breath, cough, right chest pain, fever, night sweating and decrease of body weight 1-2kg in a month. From the physical examination we found percussion dullness and decreased of lung sound in the right upper thorax examination and laboratory results and chest xray there are suspicion of Aspergillosis. The results of XpertMtb/Rif sputum examination obtained that no Mycobacterium tuberculosis, sputum KOH was not found fungus, cytological sputum was obtained as Class II, and in bacterial sputum culture obtained Klebsiella pneumonia. The patient performed a bronchoscopic examination and continued with open thoracotomy surgery and lobectomy.Conclusion: In these patient the diagnosis of lung mycosis with suspicious of Aspergillosis has gone through a multidisciplinary approach covering the pulmonology, radiology, microbiology and anatomical pathology. Collaboration between doctors, researchers, and the pharmaceutical industry is required to resolve the problem of fungal diseases and can increase the profile of these diseases.

Mediastinal Lymphohemangioma (Case Report): A (Report of a) Rare Case with Difficult Diagnosis ramadhan, fitratul; Pratiwiw, Suryanti; Isharanto, Artono; Erawati, Dini; Yudhanto, Hendy
Malang Respiratory Journal Vol. 4 No. 1 (2022): Vol. 4 No. 1
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2022.004.01.1

Mediastinal lymphohemangioma is a very rare, benign, congenital malformation. Mediastinal lymphohemangioma originates from local proliferation of lymphatic vessels. This disorder is accountable for 4.5% among all mediastinal tumors. Most lymphohemangiomas are found in the neck and axillary region among children, whereas only 1% are found in the mediastinum and tend to occur in individuals aged over 20 years old. A proper understanding is needed to be able to make a diagnosis and perform effective management of mediastinal lymphohemangiomaIn this case report, a woman with a diagnosis of mediastinal lymphohemangioma, established through a multidisciplinary approach covering the fields of pulmonology, thoracic and cardiovascular surgery, radiology, and anatomical pathology.Keywords: Mediastinal Lymphohemangioma, Core Biopsy, Thoracotomy

A Rare Case of Chylothorax Manifestation of Gorham’s Disease, Lymphangioma and Tuberculosis Agil Dananjaya; Setyawan, Ungky; Putra, Ngakan; Erawati, Dini; Isharanto, Artono; Norahmawati, Eviana; Irmansyah, Istan
Malang Respiratory Journal Vol. 4 No. 2 (2022): September 2022
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2022.004.02.1

Background: Chylothorax is a rare condition caused by accumulation of chyle in the pleural cavity (2-3%). More rare causes are Gorham's disease and tuberculosis Case: A 31-year-old male complained of swelling left arm and shortness of breath with recurrent pleural effusion. Pleural fluid analysis showed chylous. Bone survey showed osteolytic lesions of multiple bones as Gorham's disease. Thoracic CT showed left lung mass, atelectasis, massive fluidothorax, ipsilateral supraclavicular lymphadenopathy, destructive left scapula. Needleaspiration of left humerus revealed lymphangioma. Expert Mtb-Rif examination revealed Mtb detected. We assessed Gorham'sdisease, lymphangioma and lung tuberculosis with complication recurrent chylothorax and was treated anti-tuberculosis, anti-osteolytic and thorax catheter insertion. Conclusion: Difficult and rare case of chylothorax in one patient with Gorham’s disease and tuberculosis, is a poor prognosis. Keywords: Chylothorax, Gorham's Disease, Tuberculosis

Exogenous Lipoid Pneumonia Effendi, Tiar Oktavian; Setyawan, Ungky; Putra, Ngakan; Erawati, Dini
Malang Respiratory Journal Vol. 4 No. 2 (2022): September 2022
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2022.004.02.3

Background : Lipoid pneumonia is a rare disease and usually reported as sporadic cases. Exogenous lipoid pneumonia is a more common form of lipoid pneumonia. Untypical characteristics makes incidence rate of this cases are often imprecise. The diagnosis is made from a history of lipid containing material aspiration, radiologic imaging, and histopathological examination. There is no treatment of choice because diagnosis of this cases are rarely made. Case Report : We report one case at Dr. Saiful Anwar hospital, a 35 years old man with accidental kerosene ingestion and aspiration. Based on examination of the patient, laboratory results, radiological imaging, and BAL fluid analysis and cytology, diagnosis of exogenous lipoid pneumonia was made. Our treatment of choice was combination of antibiotic, corticosteroid and BAL to manage this patient. After 2 weeks of treatment, there were improvements on clinical and radiological imaging. Conclusion: Exogenous lipoid pneumonia is a rare disease. Using antibiotic, corticosteroid, and BAL through bronchoscopy can be a therapeutic option that provides clinical and radiological improvement. Key words : Lipoid Pneumonia, Exogenous Lipoid Pneumonia, Treatment of Lipoid Pneumonia

A Rare Case: Adenocarcinoma Bronchogenic Dextra Std IVB on Gefitinib (15 months) accompanied by Decreased Visual Acuity, Bilateral Sensorineural Deafness and Psychiatric Disorders with No Radiological Evidence of Brain Metastasis Ensang Timuda, Caesar; Dwi Pratiwi, Suryanti; Rahmawati, Dessika; Yudhantara, Dearisa; Erawati, Dini; Indrasworo, Dyah; Prayitnaningsih, Seskoati
Malang Respiratory Journal Vol. 4 No. 2 (2022): September 2022
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2022.004.02.2

Background: Leptomeningeal disease occurs in 3-5% of patients with lung cancer, mainly adenocarcinoma subtype. Adenocarcinoma is the most common histological finding in Asian women. Case: A 51-year-old woman with right-sided bronchogenic adenocarcinoma T4N3M1c Std IVB mutation(+) developed decreased vision, severe bilateral sensorineural deafness and psychiatric disorders after receiving Gefitinib 15 months. There was no evidence of brain metastasis from brain MRI. From evaluation of chest CT-scan, we found the disease was progressive and no Mutation Detected from ctDNA, so Gefitinib was discontinued. Conclusion: We found some difficulties in evaluating side effects of therapy and disease progression due to patient's condition in the form of decreased total vision, severe sensorineural deafness, and psychiatric disorders. However, because no radiological evidence of brain metastases was found, we suspect this patient suffered from leptomeningeal disease. Keywords: Lung Cancer, Adenocarcinoma, Gefitinib, Leptomeningeal Disease

A Thymoma (Case Report): Importance of Comorbidity, Lifestyle, and Thymoma Size in Treatment Success Suryaman, Rachmat; Djajalaksana, Susanthy; Setyawan, Ungky; Wardhana, Koernia; Erawati, Dini; Yudhanto, Hendy
Malang Respiratory Journal Vol. 4 No. 2 (2022): September 2022
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2022.004.02.4

Thymoma is a rare malignancy with an incidence of 0,15 case per 100.000 population and is the most commonly diagnosed anterior mediastinal malignancy. With 12,5% 15-year survival rate, and is often accompanied by autoimmune disease such as myasthenia gravis, pure red blood cell aplasia, and hypogammaglobulinemia, better understanding of factors affecting prognosis is needed to improve patient quality of life and survival.

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