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Journal : Indonesian Journal of Rheumatology

Post Operative Management in Intensive Care of Obstructive Jaundice caused by Choledocholithiasis: A Case Report Liliriawati Ananta Kahar; Wiwi Monika Sari
Indonesian Journal of Rheumatology Vol. 13 No. 3: Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v13i3.257

Abstract

Introduction: Gallstones are a very common problem in the global population. 10%-25% of affected people may have specific symptoms, and 1%-2% of them may experience major complications. Case presentation: 83-year-old female patient complained of yellow in her eyes and skin. Patients also felt pain in the right upper abdomen. Laboratory examination revealed increased bilirubin serum. Abdominal Ultrasound examination showed Obstruction of the Bilier Ductus caused by a stone at ductus sisticus and sludge of the gallbladder. The patient was diagnosed with Jaundice obstruction caused by obstruction of the bile ducts due to a stone at the ductus sisticus with a history of nephrectomy, Hypertension, and type 2 diabetes. The patient underwent Laparoscopic cholecystectomy, ERCP, and stent biller, After the procedure, the patient was admitted to the intensive care unit. Conclusion: Understanding the patient's comprehensive medical and surgical history is fundamental in understanding the postoperative patient in the intensive care unit. Adequate resuscitation is necessary for good clinical perfusion and physiological stability of the patient.
Critical Care Management of Myasthenic Crisis: A Case Report Liliriawati Ananta Kahar
Indonesian Journal of Rheumatology Vol. 13 No. 3: Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v13i3.263

Abstract

Background: The annual incidence of myasthenia gravis is 1-2 cases in 100,000 population. 30% of all cases will develop bulbar or respiratory muscle weakness. About 15-20% of myasthenia gravis patients will develop myasthenia crisis. Case presentation: An 18-year-old female patient complained of difficulty swallowing two days ago difficulty swallowing solid and liquid food, and this complaint caused the patient to cough and choke. Complaints were accompanied by difficulty opening the eyelids, especially in the afternoon. Complaints were also accompanied by double vision, especially when looking to the right. There was a nasal sound, and the patient had difficulty pronouncing vocal letters. The patient was admitted to ICU, In the ICU patient was intubated and given plasma exchange therapy. Conclusion: Myasthenic crisis is a neurological emergency that requires prompt diagnosis and treatment. Adequate intensive care, judicious weaning, and extubation decisions, along with specifically targeted therapy, will improve the outcome of myasthenia gravis.