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All Journal The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
L A Lesmana
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Medicine & Pharmacology

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Diseases in Chronic Non-infective Diarrhea Marcellus Simadibrata; Aziz Rani; Daldiyono Daldiyono; Ari Fahrial Syam; GNJ Tytgat; Vera Yuwono; L A Lesmana; Iwan Ariawan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 5, ISSUE 1, April 2004
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/51200415-18

Abstract

Background: Chronic diarrhea is common in Indonesia. The chronic non-infective diarrhea cases seem to be increasing recently. The aim of this study is to reveal the pattern of diseases that can cause chronic non-infective diarrhea. Methods: We examined all patients suffering from chronic non-infective diarrhea over a six years period. The patients underwent physical examination and performed laboratory tests, colon enema X-ray, colonoscopy, ileoscopy, upper gastrointestnal endoscopy and small bowel X-ray. Result: Chronic non-infective diarrhea was observed in 107 (51.7%) cases from 207 chronic diarrhea cases respectively. The frequently found abnormalities that had caused chronic non-infective diarrhea were carbohydrate maldigestion (62.61%), colorectal cancer (14.01%), Crohn’s disease (11.21%), ulcerative colitis (9.34%), irritable bowel syndrome (8.41%), colorectal polyp (8.41%) etc. Conclusion: The most frequent abnormality found in chronic non-infective diarrhea was maldigestion.   Keywords: Chronic diarrhea, non-infective
Benign Recurrent Intrahepatic Cholestases Femmy Nurul Akbar; Sjaifoellah Noer; L A Lesmana; Unggul Budihusodo; Wirasmi Marwoto
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 2, NUMBER 1, April 2001
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/21200141-44

Abstract

Benign recurrent intrahepatic cholestasis (BRIC) or idiopathic recurrent intrahepatic cholestasis is a rare case. It is a familial and autosomal recessive. The etiology of BRIC is still unknown. We report the case of a patient with BRIC who suffered from recurrent jaundice 7 times in 7 years that occurred for 1-3 months with spontaneous resolutieon. This patient received ursodeoxycholic acid, cholestiramine and prednisone. And within 2 months, the jaundice resolved together with other complaints.    Keywords: cholestasis, autosomal, familial
Abnormalities of the Small Bowel in Chronic Non-Infective Diarrhea: A Histopathological Study Marcellus Simadibrata Kolopaking; Vera Yuwono; Ari Fahrial Syam; FJW Ten Kate; GNJ Tytgat; Daldiyono Daldiyono; L A Lesmana; Nurul Akbar; Chudahman Manan; Iwan Ariawan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 4, ISSUE 2, August 2003
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/42200329-38

Abstract

Background: The incidence of chronic non-infectious diarrhea cases is increasing in line with the developments of medical technology and science. The objective of this study was to uncover the histopathologic abnormalities of the small bowel in cases of chronic non-infectious diarrhea. Methods: All chronic non-infectious diarrhea patients in Cipto Mangunkusumo Hospital from 1996 until 2000 were included in this study. For the control group, we used 37 endoscopically-normal patients with functional dyspepia with the same characteristics (sex and age). All of the patients underwent gastroduodeno-jejunoscopic and ileocolonoscopic examinations. Patients with infection were excluded from this study. Biopsies were taken from the duodenal bulb, descending duodenum, jejunum near the Treitz ligament, terminal ileum, and colon. Histopathological tests were performed on all of the biopsies. Result: Histopathological examination was carried out on 31 patients and 37 control patients. In the duodenal bulb, the width of villi, lymphocyte infiltration, eosinophil infiltration, stage of inflammation, and polymorphonuclear cells infiltration were all lower in the chronic non-infectious diarrhea group than in the control group (p 0.01). In the descending part of duodenum and jejunum, lymphocyte infiltration, the stage of inflammation, and polymorphonuclear cell infiltration were found to be higher in the chronic non-infectious diarrhea group than in the control group (p 0.01). Within the terminal ileum, lymphocyte infiltration, the stage of inflammation and lymphoid follicle hyperplasia were found to be higher in the chronic non-infectious diarrhea group than in the control group (p 0.01). Conclusion: Histopathologically, increased lymphocyte infiltration, inflammation and lymphoid follicle hyperplasia were discovered in specified areas of small intestine in chronic non-infectious diarrhea patients. Keywords: Histopathological examination, chronic non-infectious diarrhea, lymphocyte infiltration, mucosal inflammation, lymphoid follicle hyperplasia
Diagnostic Approach and Treatment of Choledocholithiasis Indah Gianawati; Ali Sulaiman; L A Lesmana; Toar JM Lalisang; Arman A Abdullah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 5, ISSUE 2, August 2004
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/52200471-75

Abstract

Choledocolithiasis may cause acute cholangitis which is life-threatening condition. It has non specific clinical signs from mild to severe condition such as septicemia. Diagnostic and treatment modalities had developed a great deal recently. Therapeutic options include endoscopic retrograde cholangio pancreatography (ERCP),common bile duct exploration (CBDE), laparoscopic CBDE and stone retrieval. The important thing is to choose the appropriate method for each patient. We reported a case of choledocolithiasis in 40 years old, male patients who was clinically diagnosed as acute cholangitis. Diagnostic approach to find the etiology was done. Abdominal USG and CT were performed and showed multiple stones in gallbladder and intrahepatic biliary duct, suspected mass at caput of the pancreas and hepatomegaly. The ERCP showed dilatation of intra and extra hepatic biliary ducts with multiple stone in common bile duct (CBD), hepatic duct and gallbladder. The stent was placed for biliary drainage. The patient underwent cholecystectomy per laparoscopy, but further evaluation of the cholangiography still showed the presence of stones in intrahepatic biliary duct. Laparotomy exploration of CBD was done and it revealed multiple stones and dilatation of distal CBD. Surgical treatment selected for this case was choledocojejunostomy. Keywords: Choledocolithiasis, CBD, diagnostic approach
Non-Surgical Biliary Drainage on Biliary Obstruction due to Malignancy Evy Yunihastuti; L A Lesmana; Ari Fahrial Syam; Irsan Hasan; Karmel Tambunan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 2, NUMBER 2, August 2001
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2220018-20

Abstract

Surgery is still the golden standard of curative therapy for malignant biliary obstruction, but only 10- 20% of cases considered resectable. Therefore, palliative therapy to relieve pain, cholestasis, and biliary obstruction, is the main treatment for most patients. The development of percutaneous transhepatic biliary drainage and endoscopic biliary drainage had brought about minimally invasive treatment for malignant biliary obstruction, which had lower morbidity and mortality than surgical drainage. The choice of drainage technique depends on type of tumor, site of obstruction, also the available expert and instrumentation.    Keywords: malignant  biliary  obstruction,  percutaneous  transhepatic  biliary  drainage, therapeutic endoscopic retrograde cholangiopancreatography
Co-Authors Ali Sulaiman Ali Sulaiman Ari Fahrial Syam Arman A Abdullah Aziz Rani Chudahman Manan Chudahman Manan Daldiyono Daldiyono Daldiyono Daldiyono Evy Yunihastuti Femmy Nurul Akbar Femmy Nurul Akbar FJW Ten Kate GNJ Tytgat Indah Gianawati Irsan Hasan Iwan Ariawan Karmel Tambunan Lies Luthariana Marcellus Simadibrata Marcellus Simadibrata Marcellus Simadibrata Kolopaking Nurul Akbar Nurul Akbar Retno Iswari T Sjaifoellah Noer Sunhadji Rubangi Toar JM Lalisang Toar JM Lalisang Unggul Budihusodo Uyainah Z Nasir Vera Yuwono Wirasmi Marwoto Wirasmi Marwoto