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All Journal Paediatrica Indonesiana The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Tan Siauw Koan
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Health Professions Medicine & Pharmacology

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Role of multidetector spiral CT scanning for pulmonary embolism confirmation in a child with pulmonary hypertension: a case report Heda Melinda Nataprawira; Sri Endah Rahayuningsih; Nono Sumarna Afandi; Armijn Firman; Tan Siauw Koan
Paediatrica Indonesiana Vol 49 No 1 (2009): January 2009
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (191.806 KB) | DOI: 10.14238/pi49.1.2009.54-8

Abstract

Pulmonary embolism (PE)  is  associated withconsiderable morbidity and mortality. Earlydiagnosis and prompt treatment  is  essential,  1 • 2however PE  is  rarely clinically diagnosed ortreated in children. Most clinically significant  PE  is  notrecognized antemortem. 3  While its diagnosis remainsa challenge  as  the signs and symptoms  can  often benon-specific,  an  accurate diagnosis  is  essential for themanagement  of  this disease. It  is  known  that  a numberof  non-invasive diagnostic tools are available for itsdetection nowadays. 1 • 2 .4  Even though multi-detectorspiral, also called helical,  CT  scanning  is  promisingand has  been  proven to be useful  in  diagnosing thiscondition with high sensitivity  and  specificity, 5  it  isunavailable even  in  referral hospitals  in  Indonesia.The  gold  standard,  pulmonary  angiography,  isconsidered  as  the procedure of choice to diagnose PE,but  unfortunately it  is  invasive. Failure to diagnose PEaccurately and promptly  can  result in excess morbidityand  death  due to pulmonary hypertension (PH) andrecurrent venous thromboembolic events. Conversely,unnecessary  anticoagulation  therapy poses a riskwithout any benefit.2
Tuberculous Splenic Abscesses as an Etiology in Prolonged Fever Dolvy Girawan; S A Abdurachman; Iman Supandiman; Hadi Jusuf; Tan Siauw Koan; Warko Karnadihardja
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 6, ISSUE 3, December 2005
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/63200588-90

Abstract

Extra-pulmonary tuberculosis covers all forms of tuberculosis in which the disease process occurs outside the lungs. Tuberculosis is one of the common infectious causes of splenic enlargement, but tuberculous splenic abscess is a rare presentation. We report the finding of tuberculous multiple splenic abscesses in a young male patient aged 33 years with prolonged fever. The main clinical feature was fever for 6 months prior to admission. Abdominal ultrasound revealed the spleen was normal in size but showed multiple abscesses. CT scan abdomen showed splenomegaly with multiple solid nodules. Patient underwent laparatomy and splenectomy, the spleen indeed showed multiple abscesses. Histopatology Result showed Langhan’s multi nucleated giant cells, caseous necrosis. The patients was diagnosed to have tuberculous multiple abscesses of the spleen. The patient was started  on  daily  short-course  antituberculosis  drugs  with  isoniazid,  rifampicin, pyrazinamide and ethambutol. He responded well to oral antituberculosis treatment.   Keywords: prolonged fever, abdominal ultrasound, CT scan abdomen, tuberculosis, multiple splenic abscesses, splenectomy
Co-Authors Armijn Firman Dolvy Girawan Hadi Jusuf Hadi Jusuf Heda Melinda Nataprawira Iman Supandiman Iman Supandiman Nono Sumarna Afandi S A Abdurachman Sri Endah Rahayuningsih Warko Karnadihardja