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All Journal Medical Journal of Indonesia Makara Journal of Health Research The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia

Dadang Makmun

Division Of Gastroenterology, Department Of Internal Medicine, Faculty Of Medicine/Dr. Cipto Mangunkusumo General National Hospital, Jakarta

Author-ID : 312963

Medicine & Pharmacology

Published : 59 Documents Claim Missing Document

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A Case of Primary Ileocecal Lymphoma Wulyo Rajabto; Djumhana Atmakusuma; Ivan Onggo S; Dadang Makmun
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 17, No 3 (2016): VOLUME 17, NUMBER 3, December 2016
Publisher : The Indonesian Society for Digestive Endoscopy

Primary lymphoma in gastrointestinal tract is not very common. Ileocecal region is the commonest site for primary lymphoma and diffuse large B cell lymphoma (DLBCL) is the most prevalent subtype. The clinical presentation in this condition is pain in right lower quadrant region and this can very confusing since many diseases can also cause this problem like infection and inflammatory disease. In this paper, we report a case of primary lymphoma subtype DLBCL in ileocecal region that come to emergency department with ileus obstruction. Abdominal computerized tomography (CT) scan and colonoscopy revealed tumour in ileocecal region ascendens colon. Hemicolectomy was performed and the specimen was sent to pathology which revealed non-Hodgkin lymphoma with subtype DLBCL CD20 (+). The patient had undergone of Rituximab, Cyclophosphamide, Doxorubicine, Vincristin, and Prednison (RCHOP) chemotherapy regimen and had complete remission.

Current Diagnostic Approach of Inflammmatory Bowel Disease Anggilia Stephanie; Dadang Makmun
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 15, No 1 (2014): VOLUME 15, NUMBER 1, April 2014
Publisher : The Indonesian Society for Digestive Endoscopy

Inflammatory bowel disease (IBD) has begun to emerge in Indonesia. The disease is further classifiedinto two types, ulcerative colitis (UC) and Crohn's disease (CD). Diagnosis of IBD is initiated from symptomfindings such as diarrhea, abdominal pain, bleeding diarrhea, and weight loss, and supported by physicalexamination and additional tests. The options for additional examinations of IBD are mainly endoscopy (esophagogastroduodenoscopy, colonoscopy, and also intestinal endoscopy), imaging techniques, and laboratory examinations either from blood or feces. The application of these modalities should be prompted by sufficientclinical suspicion to promote their efficiency as well as prevent underdiagnosis or overdiagnosis. In primaryhealth care settings, patients with IBD are expected to be recognized for therapy or to use appropriate referralsystem to warrant a proper treatment.Keywords: inflammatory bowel disease, diagnosis terkini, kolitis ulseratif, penyakit Crohn ABSTRAKInflammatory bowel disease (IBD) mulai banyak ditemukan di Indonesia. Penyakit ini terbagi atas dua jenisyaitu kolitis ulseratif (KU) dan penyakit Crohn (PC). Diagnosis IBD dimulai dari gejala yang ditemukan sepertidiare, nyeri perut, buang air besar berdarah dan penurunan berat badan, serta didukung oleh pemeriksaan fisikdan pemeriksaan penunjang. Pilihan pemeriksaan penunjang untuk IBD secara garis besar adalah endoskopi(esofagogastroduodenoskopi, kolonoskopi maupun endoskopi usus halus), pencitraan, dan pemeriksaanlaboratorium, baik dari darah atau feses. Penggunaan berbagai modalitas ini harus didahului adanya kecurigaanyang cukup secara klinis agar tepat guna, mencegah under- atau overdiagnosed. Pada tingkat layanan primer,pasien IBD juga diharapkan dapat ditemukan untuk diterapi atau menggunakan sistem rujukan yang tepat agar ditatalaksana dengan baik.Kata kunci: inflammatory bowel disease, diagnosis terkini, kolitis ulseratif, penyakit Crohn

Management of Gastroesophageal Reflux Disease (GERD) Dadang Makmun
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: 10.24871/21200121-27

Even though there are still no epidemiological data on the prevalence of Gastro Esophageal Reflux Disease (GERD) in Indonesia, data from The Division of Gastroenterology Department of Internal Medicine Cipto Mangunkusumo Hospital demonstrate signs of esophagitis in 22.8% of all patients with dyspepsia who underwent endoscopic examination. Western countries report a higher rate of GERD than Asian and African countries, possibly due to dietary factors and increased obesity. Besides adequate history and physical examination, there are many other supporting examinations that could be performed to establish the diagnosis of GERD, especially endoscopy of the upper gastrointestinal tract and 24-hour esophageal pH monitoring. Even though this condition is rarely fatal, GERD patients should still receive adequate management. Most patients demonstrate a satisfactory response towards therapy, which includes life-style modification as well as medication. Currently, the drugs of choice for GERD are proton-pump inhibitors. A combination of proton-pump inhibitors and prokinetics produces a better effect. Patients resistant to medical treatment or those with recurrent esophageal stricture should be considered for anti-reflux surgery. Keywords: gastroesophageal reflux, diagnosis, prokinetics, proton-pump inhibitor.

Clinical Profile and Outcome of Non-Variceal Upper Gastrointestinal Bleeding in Relation to Timing of Endoscopic Procedure in Patients Undergoing Elective Endoscopy Lianda Siregar; Abdul Aziz Rani; Chudahman Manan; Marcellus Simadibrata; Dadang Makmun
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 3, December 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Endoscopy is the most accurate method for diagnosing the source of upper gastrointestinal bleeding. This study was aimed to evaluate the correlation between the timing of elective endoscopy and the length of hospital stay, the amount of transfusion given and incidence of recurrent bleeding or patient mortality. Method: A retrospective study was conducted in all patients with non-variceal upper gastrointestinal bleeding who had experienced elective endoscopy at Cipto Mangunkusumo Hospital between January 2007 and August 2008. Identification of clinical risk using clinical Rockall score was performed at the emergency room. Persistent bleeding, recurrent bleeding, surgical treatment and death were the outcome variables. Statistical analysis was performed using Chi-square/fisher exact test and linear regression. Results: There were 40 eligible cases with mean age of 53 ± 13 years; the greatest occurrence was at the age group of 50-59 years (12%), male (52.5%) and those who had clinical symptom of melena (52.5%). Twenty seven (67.5%) patients had Rockall score of 1-3 points and 13 (32.5%) had 4-6 points. There was only one patient who had adherent clots (Forrest grade II B). Endoscopy results revealed that the most common cause of bleeding was gastric ulcer, which occurred in 12 (30%) patients. There was no correlation between the timing of endoscopic procedures and outcome variable; however the length of hospital stay had a significant correlation with timing of endoscopic procedures. Conclusion: Elective endoscopy does not affect the variables of mortality and recurrent bleeding; however, it affects the length of hospital stay. Further prospective studies are required to find causal relation between them. Keywords: non-variceal upper gastrointestinal bleeding, Rockall score, elective endoscopy, outcome variables

Mirizzi Syndrome in Gallstone Complication Ario Perbowo; Dadang Makmun
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 15, No 2 (2014): VOLUME 15, NUMBER 2, August 2014
Publisher : The Indonesian Society for Digestive Endoscopy

Mirizzi syndrome is a rare complication of gallstone which is characterized by the presence of gallstone impaction in cystic duct that leads to inflammatory stricture in the biliary duct and results in obstructive jaundice. In this report, we highlighted the diagnostic approach and management of Mirizzi syndrome in a 58 year-old male complaining of nausea, vomiting, and appearing jaundice. The role of imaging such as abdominal ultrasonography in depicting the characteristics of Mirizzi syndrome was also discussed and compared the findings with the classification of the disease in the literature. In this patient, Mirizzi syndrome was suspected by the appearance acoustic shadow in the gallbladder with dilated cystic duct suggesting the impaction of common bile duct (CBD). We performed endoscopic retrograde cholangiopancreatography (ERCP) as both diagnostic and therapeutic modalities by which we allowed sphingterectomy to evacuate the gallstone. However, due to the risk of further stone evacuation, the procedure was followed by elective cholecystectomy. Keywords: gallstone, Mirizzi syndrome, complication

Gastric pH Comparison Between Mild and Severe Cirrhotic Portal Hypertensive Gastropathy Asep Saepul Rohmat; Dadang Makmun; Irsan Hasan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 15, No 2 (2014): VOLUME 15, NUMBER 2, August 2014
Publisher : The Indonesian Society for Digestive Endoscopy

Background: One of the causes of upper gastrointestinal bleeding in patients with liver cirrhosis is thepresence of portal hypertensive gastropathy (PHG). The prevalence of PHG in patients with liver cirrhosis isquite high but there is still inconsistency regarding the studies about gastric pH in cirrhosis patient. The aim of this study is to compare the gastric pH in mild and severe PHG due to liver cirrhosis.Method: Cross sectional method with consecutive sampling was done to all liver cirrhotic patients who came to Clinic of Gastroenterology and Hepatology in Cipto Mangunkusumo hospital from March to May 2014. Sixtytwo patients with portal hypertensive gastropathy underwent endoscopy to measure the degree of gastropathy based on Mc Cormack classification ad the mean basal gastric pH using pH-metric.Results: There are 50 (80.6%) male patients and 12 (19.4%) female patients participated in this study. Portal hypertensive gastropathy is mostly caused by hepatitis C (56.5%), hepatitis B (32.3%), non-hepatitis (8.1%) and alcohol (3.2%). The mean of gastric pH in all liver cirrhosis patients with portal hypertensive gastropathy was 2.13.The mean gastric pH in liver cirrhosis patient with mild portal hypertensive gastropathy (2.00 mEq/L) was lower than the gastric pH in severe portal hypertensive gastropathy (2.25 mEq/L) with significant differences (p0.05)Conclusion: The gastric pH in liver cirrhosis patient between mild and severe portal hypertensive gastropathy are significantly different Keywords: gastric pH, liver cirrhosis, portal hypertensive gastropathy, pH-metric

Paradigm on Chronic Constipation: Pathophysiology, Diagnostic, and Recent Therapy Laurentius Aswin Pramono; Ahmad Fauzi; Ari Fahrial Syam; Dadang Makmun
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 3, Desember 2012
Publisher : The Indonesian Society for Digestive Endoscopy

ABSTRACTChronic constipation is a medical gastrointestinal problem which can degrade patient’s quality of life. So far, the shifting pathophysiologic mechanism to colonic neuropathology has not been supported by diagnostic facility and therapy. Target therapy for chronic constipation related to enteric nervous system is still limited to study. Currently, the discovery of neurotrophin-3 has not shown any significant development needed in daily clinical practice. Until now study related to endoscopic full-thickness biopsy has not been done in human and waiting for its applications in daily practice. Targeted therapy for chronic constipation which is related to enteric nervous system is still limited to study. The discovery of neurotrophin-3, although currently on clinical trial phase II, still not showing any significant contribution in daily clinical practice. New pathophysiologic mechanism shifting the ‘idiopathic’ paradigm or ‘functional’ to colonic neuropathology has not been met with diagnostic modalities and therapy based on this knowledge. Study regarding endoscopic full-thickness biopsy to help revealing this novel mechanism has not been done in human. Henceforth, until now applied studies pertinent to this subject are longing in order for enteric neuron etiology can be firmly established Thus, in the future, translational study is demandingly needed for a firm establishment of diagnostic and therapeutic modalities to its currently evolving pathophysiology. Keywords: chronic constipation, colon, enteric nervous system, neurotophin-3

The Profile of Hospitalized Patients with Esophageal Cancer at Dr. Cipto Mangunkusumo General National Hospital in 2002-2008 Bambang Sutopo; Dadang Makmun; Marcellus Simadibrata
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, ISSUE 2, August 2009
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/102200966-69

Background: Esophageal cancer is a rare but fatal disease. Neither data nor patterns of the disease have been published in Indonesia. Therefore, we aim to identify the profiles of patients with esophageal cancer who were hospitalized at Cipto Mangunkusumo hospital. The objective of our study was to recognize the prevalence of esophageal cancer, characteristics of the disease, diagnostic procedures and the treatment. Method: This was a retrospective study. The data was obtained from medical records of patients with esophageal cancer who were hospitalized at Cipto Mangunkusumo hospital from 2002 to 2008. Results: Twenty three patients, 13 males, were diagnoses with esophageal cancer during 2002–2008. All diagnoses were confirmed by histological examinations. Almost all patients were anemic at first presentation, but hipoalbuminemia were observed only in three patients. CT scan examination was more superior to chest X-ray and abdominal ultrasonography on detecting distant metastasis. Esophageal mass at 1/3 proximal of esophagus was found in four patients during endoscopic examination; while seven patients had esophageal mass located at 1/3 mid-portion of esophagus and 12 patients had esophageal mass located at 1/3 distal of the esophagus. Histological findings showed that 11 patients had adeno-carcinomas, eight patients had squamous cell carcinomas, three patients had squamous- adenocarcinomas and a patient was suspected to have sarcoma. Therapeutic measures had been done for 10 patients including gastrostomia in six patients, gastroesophageal resection in two patients and two patients received chemotherapy. Conclusion: We found that adenocarcinomas is more common than squamous-cell carcinomas among patients with esophageal cancer. Almost all esophageal cancer patients came to the hospital in late stage. Keywords: esophageal cancer, adenocarcinomas, squamous-cell carcinomas, squamous- adenocarcinomas, sarcomas

Imaging Modalities Role inRecurrent Acute Pancreatitis Diagnosis Andreas Pekey; Rio Zakaria; Leonard Nainggolan; Ari Fahrial Syam; Dadang Makmun
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 15, No 3 (2014): VOLUME 15, NUMBER 3, December 2014
Publisher : The Indonesian Society for Digestive Endoscopy

Recurrent acute pancreatitis (RAP) is a potentially life-threatening pancreatic disorder. Itrequires a combination of medical and interventional skills to diagnose, determine the etiology, and treat the condition. Recurrencesoccur in 25-30% of all acute pancreatitis cases. The most common cause of RAP is gallstone (microlithiasis). Imaging modalities become an important aspect to evaluate multiple microlithiasis. In this case, we report a 52 years oldoverweight female with RAP and fatty liver ofunknown etiology.We suspected gallstone as the cause of RAP. Physical examination considered normal. Ultrasound and abdominal CT scan wasperformed in whichfatty liver were founded. Since the gallstone is not clearly found with radiologic imaging, we decide to undergoEndoscopic Retrograde Cholangiopancreatography(ERCP)procedure to evaluatea possibility of microlithiasis. ERCPresult showed a multiple microlithiasis, thus we evacuate the stones. Clinical outcome post ERCP and evacuationprocedure was good. We concluded that the best imaging modalities to evaluate microlithiasis in RAP with normal ultrasound and abdominal CT scan is ERCP. Keywords:recurrent acute pancreatitis (RAP), microlithiasis, endoscopic retrograde cholangiopancreatography (ERCP).

Fecal Calprotectin Level as Diagnostic Marker for Intestinal Inflammation in Inflammatory Bowel Disease Patients Darmadi -; Dadang Makmun; Andri Sanityoso; Hamzah Shatri
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 16, No 3 (2015): VOLUME 16, NUMBER 3, December 2015
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Inflammatory bowel disease diagnosis was still based on invasive examination, such as endoscopy and histopathology. Fecal calprotectin was a non-invasive intestinal inflammation marker, but several study give a different result in its diagnostic value and correlation to inflammatory bowel disease. This research was aimed to prove that fecal calprotectin examination has a high diagnostic value in diagnosing inflammatory bowel disease, and also correlate to its clinical stages.Method: This is a cross sectional study to do a diagnostic test in several hospital in Jakarta, from September 2014 to February 2015. Receiver operating characteristic (ROC) curve was made to get fecal calprotectin diagnostic level and Krusskal Wallis test was performed to identify fecal calprotectin difference among each inflammatory bowel disease clinical stages.Results: A total of 71 patients with inflammatory bowel disease was invoved in this research, based on colonoscopic examination result. Among them, 57 patients was confirmed to have intestinal inflammation based on histopathology result. Fecal calprotectin level was found to be higher in patients with inflammatory bowel disease than patients without intestinal inflammation (553,8 µg/g vs. 76,95 µg/g, p 0,001). A cut off point of 179,3 µg/g was gathered, with 96% sensitivity (95% CI: 0,88-0,99), 93% specificity (95% CI: 0,69-0,99), and 99,5% area under curve (AUC) 99,5% (95% CI: 0,98-1,00). A significant difference was found between fecal calprotectin in each inflammatory bowel disease clinical stages (p 0,001).Conclusion: Fecal calprotectin has a high diagnostic value for inflammatory bowel disease (IBD) and strongly correlate to its disease clinical stages.

Co-Authors -, Darmadi Aan Santi Aan Santi Aan Santi Abdul Aziz Rani Abdul Aziz Rani Abdul Aziz Rani Abdul Aziz Rani Achmad Fauzi Achmad Fauzi ACHMAD FAUZI Adang Bachtiar Adi Winarto Ahmad Fauzi Ali Imron Yusuf Amanda P Utari, Amanda P Andreas Pekey Andreas Pekey, Andreas Andri Sanityoso Andri Sanityoso Anggilia Stephanie Anggilia Stephanie, Anggilia Anna Mira Lubis Ardani, Yanuar Ari F Syam Ari F Syam Ari Fahrial Syam Ari, Franciscus Ariadno, Aru Ario Perbowo Ario Perbowo, Ario Arnold Hasahatan Harahap Artati Murwaningrum, Artati Asep Saepul Rohmat Asep Saepul Rohmat, Asep Saepul Bambang Sutopo Barry A Putra Bona Adhista Budi Tan Oto C Rinaldi A Lesmana Catarina Budyono Catarina Budyono, Catarina Cecep Kusmana Chudahman Manan Chudahman Manan Chudahman Manan Czeresna H. Soejono, Czeresna H. Daldiyono Daldiyono Daldiyono Daldiyono Daldiyono Hardjodisasto Darmadi - Dasril Nizam Deddy Gunawanjati Dharmika Djojoningrat Diah Rini Handjari Diah Rini Handjari Diana Sunardi Djumhana Atmakusuma Djumhana Atmakusuma, Djumhana Dondin Sajuthi E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Ekowati Rahajeng Ekowati Rahajeng Elli Arsita Elli Arsita Ening Krisnuhoni Erni Sulistiawati Faisal, Edward Fauzi Ahmad Muda Femmy Nurul Akbar Femmy Nurul Akbar Franciscus Ari Fransiscus Ari Fransiscus Ari, Fransiscus Guno, Tri Hapsoro Hamzah Shatri Hapsari, Puspita FC Hasan Maulahela Hasan Maulahela, Hasan Hayatun Nufus Hayatun Nufus Hendra Agustian, Hendra Hilda Nurmalihah I Gusti Bagus Wiksuana Ifransyah Fuadi, Ifransyah Ikhwan Rinaldi Indra Marki Indra Marki Irsan Hasan Irvianita, Vinandia Ivan Onggo S Jaffray DP Rambak Jeffri Gunawan Joseph JY Sung Juferdy Kurniawan Juliyanti - Juliyanti -, Juliyanti Julwan Pribadi Kaka Renaldi Katharina Setyawati Laurentius Aswin Pramono Laurentius Aswin Pramono Leonard Nainggolan Leonard Nainggolan Lianda Siregar Lugyanti Sukrisman Marcellus Simadibrata Marcellus Simadibrata Marcellus Simadibrata Marcellus Simadibrata Marcellus Simadibrata Moch Ikhsan Mokoagow Mohammad Adi Firmansyah Mulia Mulia Murdani Abdulah Murdani Abdullah Murdani Abdullah Murdani Abdullah Murdani Abdullah Murdani Abdullah Murdani Abdullah Nana Supriana Nikko Darnindro Nikko Darnindro Novie Rahmawati Zirta Nur Rasyid Nur Rasyid Nurul Akbar Nurul Akbar Oktaramdani, Tessa Paulus Kusnanto Purwita Wijaya Laksmi Putra, Barry A Radhiyatam Mardhiyah, Radhiyatam Riahdo Saragih Rio Zakaria Rio Zakaria Rolan Sitompul Roy Soetikno Rudi Putranto Rudy Hidayat Rudy Kurniawan Rumagesan, Djahalia S, Ivan Onggo S.M. Lumban Tobing Sedijono Sedijono Segal Abdul Aziz, Segal Abdul Sepmeitutu, Iwandheny Seri Mei Maya Ulina Siti Setiati Steven Sumantri Suhendro Suhendro Suhendro Suhendro Sukamto Koesnoe Sulaiman, Andri S Suryantini Suryantini Suryantini Suryantini Syahidatul Wafa, Syahidatul Tandan, Manu Teddy Septianto Telly Kamelia Telly Kamelia Tessa Oktaramdani Tjahjadi Robert Tedjasaputra Tri Hapsoro Guno Triyanta Yuli Pramana Wulyo Rajabto Yusuf Misbach Zulkifly, Steven

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