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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

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Gastrointestinal Endoscopy in the Time of Covid-19 Pandemic: Current Guidelines and Experience From Indonesian Tertiary Endoscopy Centre Hasan Maulahela; Jaffray DP Rambak; Hilda Nurmalihah; Kaka Renaldi; Achmad Fauzi; Murdani Abdullah; Marcellus Simadibrata; Ari F Syam; Roy Soetikno; Dadang Makmun
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 21, No 1 (2020): VOLUME 21, NUMBER 1, April 2020
Publisher : The Indonesian Society for Digestive Endoscopy

Coronavirus disease-19 (COVID-19) is a respiratory disease caused by novel SARS-CoV-2. The disease has become a global pandemic since March 2020. Transmission of the disease is rapid and contagious through droplets and contaminated environments. Meanwhile, gastrointestinal endoscopy is a procedure that has a high risk of transmitting COVID-19. Proper strategies are needed to prevent transmission of the virus in the endoscopic unit. Some literature has published the guidelines for prevent COVID-19 in endoscopic units such as guidelines by AGA, APSDE, ESGE and ESGENA. These guidelines state that strategies for prevent the COVID-19 transmission in endoscopy unit must be done from before the procedure, during the procedure until after the procedure. These strategies must be followed by all patients and health care providers who working in endoscopy units.

Clinical Scoring of Positive Histophatology Findings for Inflammatory Bowel Disease at Four Hospital in Jakarta Dasril Nizam; Marcellus Simadibrata; Chudahman Manan; Dadang Makmun; Murdani Abdullah; Adang Bachtiar
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 2, August 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/112201071-74

Background: Inflammatory bowel disease (IBD) in the form of Crohn’s disease (CD) or ulcerative colitis (UC) is chronic IBD which still difficult to diagnose and clinically characterized by exacerbation and spontaneous remission. A precise diagnosis is needed and essential for appropriate treatment. Most of internists in Indonesia have to cope with a condition of poorly equipped endoscopic facilities - especially colonoscopy and subsequently refer their patients to endoscopic centers with colonoscopy facilities as well as sending biopsy specimens for histopathology examination. They also should be concerned that it would be expensive, time- consuming, and patients may suffer from considerable distress while waiting for the results of diagnostic confirmation. Therefore, we were interested in studying the clinical scoring for IBD to determine the diagnosis of possible IBD by assessing the combination of clinical reporting aspects, identification of probable IBD and histopathology examination Method: The study design was cross-sectional. We collected data pertinent to this study from medical records of patients with IBD clinical features at the endoscopic units of four hospitals in Jakarta between 1999 and 2009. Student t-test and logistic regression analysis were used for the statistic examination. Results: Based on colonoscopy examination, there were 213 patients with positive IBD and 173 patients with negative results. Histopathology results were considered as the gold standard in diagnosis of IBD. The mean clinical score was 9 (nine) points. Subjects with positive histopathology findings were significantly had higher average score than those with negative histopathology findings. Using ROC curves, we found cut-off score of 10 points with a sensitivity and specificity of 73% and 88% consecutively; while by applying logistic regression analysis, we found odds ratio (OR) of 20 (9.9-40.0 Conclusion: The clinical scoring for IBD is a valuable diagnostic tool in determining definitive diagnostic of IBD based on histopathology findings Keywords: clinical scoring, histopathology findings, definitive IBD

Post-Endoscopic Retrograde Cholangiopancreatography Complications at Dr. Cipto Mangunkusumo General Hospital Rolan Sitompul; Achmad Fauzi; Dadang Makmun; Murdani Abdulah; Ari Fahrial Syam; 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: 10.24871/102200941-45

Background: This study retrospectively evaluated post-endoscopic retrograde cholangiopancreatography (ERCP) complications at Cipto Mangunkusumo hospital in order to improve management of a subsequent prospective study of post-ERCP complications.Method: The indications, findings, diagnostic or therapeutic procedure, cannulation, devices used during the procedure, and complications of patients treated consecutively with ERCP between January 2004 and November 2008 were evaluated retrospectively.Results: Of 176 ERCP patients who were initially evaluated, 38% had undergone diagnostic ERCP and 62% therapeutic ERCP. The median age of the patients was 49 years (range 18–80 years); 95 (53.9%) were male. Only 54 of these 176 procedures could be evaluated for post-ERCP complications. A computed tomographic abdominal scan or magnetic resonance cholangio-pancreatography was performed in 23 (42.6%) patients and a biliary sphincterotomy in 14 (25.9%) patients. The overall complication rate was 33.3%: 14.8% after diagnostic ERCP and 18.5% after therapeutic ERCP. The complications after diagnostic ERCP were pancreatitis in 3 (15%) patients, cholangitis in 3 (15%) patients, hemorrhage in 1 (5%) patient, pancreatitis and hemorrhage in 1 (5%) patient; the complications after therapeutic ERCP were pancreatitis in 6 (17.6%) patients, cholangitis in 3 (8.8%) patients, hemorrhage in none, and concomitant pancreatitis with hemorrhage in 1 (2.9%) patient. No significant difference was observed between the complication rates and the type of ERCP performed.Conclusion: There were no differences in the complications after diagnostic and therapeutic ERCP. As our study shows the post-ERCP complication rate to be higher than those of other large retrospective and prospective studies, we must evaluate it in a prospective study.Keywords: post-ERCP, complications, therapeutic ERCP, diagnostic ERCP

Effect of Intravenous Polyunsaturated Fatty Acids Administration on Gastric Mucosal Integrity in Pig-tailed Macaques with Obstructive Jaundice Dadang Makmun; Dondin Sajuthi; Daldiyono Daldiyono; Adi Winarto; Erni Sulistiawati
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 1, April 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Acute gastric mucosal injury commonly occurs in patients with obstructive jaundice. We studied the effect of intravenous polyunsaturated fatty acids (PUFA) administration on gastric mucosal integrity in pig-tailed macaques (Macaca nemestrina) with obstructive jaundice by ligating common bile duct (CBD). Method: The study was conducted between February 2009 and May 2010 at the Primate Research Center, Bogor Agricultural Institute. Eight selected male pig-tailed macaques with 6.625 ± 0.83 kg of body weight were used and divided into two groups. In both groups, laboratory examination, including liver function tests and upper gastrointestinal endoscopy were performed before CBD ligation and every two weeks after ligation. In the first group, intravenous PUFA with the dose of 2 g/day was administered every day since four weeks post-ligation up to four weeks later, and in the second group, intravenous PUFA was administered since before ligation up to eight weeks later. Results: In both groups, increased total bilirubin, direct bilirubin, indirect bilirubin, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and gamma glutamyl transpeptidase were obviously found, meanwhile decreased albumin level was detected and the cholinesterase level of both groups remained unchanged. Ulcer formation occurred among the first group during 4 weeks after CBD ligation, and these ulcers showed obvious healing within four weeks after intravenous PUFA administration. In the second group, there was no significant ulcer formation within eight weeks after CBD ligation. Conclusion: The potential appearance of acute gastric mucosal injury which reflected by ulcer formation in pig-tailed macaques with obstructive jaundice was significantly decreased by intravenous PUFA administration. We also have successfully developed animal model of obstructive jaundice by CBD ligation, based on the result of liver function tests. Keywords: acute gastric mucosal injury, intravenous PUFA administration, obstructive jaundice, pig- tailed macaques

The Role of Esophageal pH-metri Test on Gastro-Esophageal Reflux Disease Diagnosis Katharina Setyawati; Murdani Abdullah; Ari Fahrial Syam; Achmad Fauzi; Dadang Makmun; Marcellus Simadibrata; Chudahman Manan; Abdul Aziz Rani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 9, ISSUE 3, December 2008
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/93200891-97

Gastro-esophageal reflux disease is a pathological condition of esophagus which is caused by gastric content reflux into esophagus. There is an increased prevalence of gastro-esophageal reflux disease. The roles of esophageal pH-metry in clinical application include looking for abnormal acid exposure on esophagus with no abnormality found in endoscopy; evaluating patients following the anti-reflux surgery who are being suspected for abnormal esophageal reflux; evaluating patients with normal endoscopic result but still having refractory reflux symptoms against proton pump inhibitor medication; detecting refractory reflux in patients chest pain following the heart evaluation; evaluating patients with otolaryngologic manifestations (laryngitis, pharyngitis, chronic cough) of the esophageal reflux disease after therapeutic failure of 4-weeks proton pump inhibitor treatment; and looking for correlation between adult onset gastro-esophageal reflux disease and non-allergic asthma. Keywords: gastro-esophageal reflux disease, esophagus pH-metry, symptoms-reflux correlation

Management of Recurrent Cholangitis in Patient with Iatrogenic Bile Duct Stricture Tessa Oktaramdani; Ari Fahrial Syam; Dadang Makmun
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

Iatrogenic bile duct stricture is the most common causes of benign bile duct stricture. Several studies reported that approximately 80% of benign strictures occur following injury during a cholecystectomy. Strictures of the biliary tract have a broad spectrum of manifestations, ranging from mild elevation of liver enzymes to life-threatening infections such as cholangitis, liver abscess, and biliary cirrhosis. Moreover, due to its indolent course with subtle clinical manifestations, diagnosis is often delayed and most patients present with a protracted, complicated course. We reported a case of 26 years old female with recurrent cholangitis due to iatrogenic bile duct stricture. Biliary drainage through endoscopic approach followed by surgical procedure was selected as strategic management for the patient.

Endoscopic Ultrasonography (EUS) Compared with Magnetic Resonance Cholangiopancreatography (MRCP) in Diagnosing Patients with Malignancy Causing Obstructive Jaundice Kaka Renaldi; Rudy Kurniawan; Dadang Makmun
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 22, No 1 (2021): VOLUME 22, NUMBER 1, April 2021
Publisher : The Indonesian Society for Digestive Endoscopy

Background: The common etiologies of obstructive jaundice were biliary stone and biliary neoplasms. The gold standard to diagnose malignancy causing obstructive jaundice is endoscopic retrograde cholangiopancreatography (ERCP) with sensitivity and specificity of 95% and 100%. However, ERCP is an invasive procedure associated with several complications such as bleeding, pancreatitis, and perforation. Other modalities include endoscopic ultrasonography (EUS) and magnetic resonance cholangiopancreatography (MRCP). Thus, we aim to evaluate the sensitivity and specificity of EUS with MRCP in patients with malignancy causing obstructive jaundice.Method: This was a cross-sectional study that calculates the sensitivity and specificity of EUS and MRCP in diagnosing malignancy causing obstructive jaundice compared with the gold standard, histopathology examination from ERCP. The study was conducted in the Medical Record Unit, Gastroenterology Division, Dr. Cipto Mangunkusumo National General Hospital, on January – March 2019 by using a consecutive sampling method. The date of diagnosis was collected from the medical record within five years. Subjects were selected based on inclusion criteria which include patients aged ≥ 18 years old who were diagnosed with malignancy causing obstructive jaundice by ERCP, and had underwent EUS or MCRP with a maximum interval of 3 months to ERCP. The exclusion criteria include patients with previous evidence of biliary tract malignancy or concurrent parenchymal jaundice. Statistical analysis was performed using IBM SPSS Statistics 20.Results: There were 54 subjects with a mean age of 56.48 ± 11.37 years. Subjects consisted of 29 (53.7%) males and 25 (46.3%) females. The median period between EUS to ERCP was 0-33 days, while MRCP to ERCP was 1-53 days. The sensitivity, specificity, positive predictive value, and negative predictive value to diagnose obstructive jaundice due to malignancy were 96%, 60%, 96%, 60% in EUS, and 90%, 40%, 94%, 29% in MRCP, respectively.Conclusion: EUS was more superior to MRCP in the diagnosis of malignancy causing obstructive jaundice.

Gastroduodenal Mucosal Integrity and Influencing Factors Dadang Makmun
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: 10.24871/63200575-79

Gastroduodenal mucosal integrity has important role in the pathogenesis of gastroduodenal ulcer. It depends on imbalance between aggressive and defensive factors. However, many experts believe that defensive factors has more dominant role. Maintenance of gastrointestinal endothelial integrity appears to define the “cytoprotection” phenomenon and, as discussed below, is a critical component of NSAID- induced GI injury and a potential target for therapeutic intervention. Keywords: mucosal integrity, aggressive factors, defensive factor, cytoprotection

Diagnostic and Therapeutic Approach in Intestinal Tuberculosis Tri Hapsoro Guno; Barry A Putra; Telly Kamelia; Dadang Makmun
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 17, No 2 (2016): VOLUME 17, NUMBER 2, August 2016
Publisher : The Indonesian Society for Digestive Endoscopy

Tuberculosis was still a global health problem. Beside lung, tuberculosis also manifest in other organs, one among them is in abdominal organs. Abdominal tuberculosis was a complex disease with unspecific sign and symptoms so that its diagnostic procedure was not rarely inconclusive. We reported a 24 years old woman with chief complain of worsening abdominal pain in all region, accompanied by nausea, vomiting, bloating, and absent bowel movement. She also had a fresh bloody stool. She had an active pulmonary tuberculosis on initiation phase treatment. Physical examination suggest a bowel obstruction sign with distended abdomen and increase bowel sound. Colonoscopy procedure findings was a mass that obstruct bowel lumen in ileocaecal region, suggest for malignancy similar to computerized tomography (CT) scan result, but pathlogic result showed an active colitis without any sign of malignancy. Because of its contradiction, the second colonoscopy was performed and concluded as intestinal tuberculosis, matched with second pathologic examination. Although polymerase chain reaction (PCR) tuberculosis (TB) showed a negative result, a further clinical judgement concluded this as an intestinal tuberculosis case. Patient was finally treated as intestinal tuberculosis with first-line antituberculosis drugs and planned to have colonoscopy evaluation. After general condition was good and obstructive ileus sign was relieved, patient planned for outpatient care.

Abdominal Disturbances among Dengue Fever Patients Arnold Hasahatan Harahap; Marcellus Simadibrata; Dadang Makmun; Irsan Hasan
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: 10.24871/102200970-74

Background: Abdominal disturbances are common symptoms found in approximately 40% of patients with dengue fever, which frequently cause significant morbidity. This study was developed as an attempt to understand the effect of plasma leakage in dengue hemorrhagic fever; particularly on ab dominal problems. Method: The study was conducted in hospitalized patients who were diagnosed with dengue fever and dengue hemorrhagic fever (based on the 1997 WHO criteria for DHF) at Fatmawati hospital, Jakarta, Indonesia. Abdominal ultrasonography (USG) was done on the fourth to sixth day in every patient and when necessary, endoscopy was done. Data were analyzed by Chi-square test. Results: Fifty-three (54.6%) patients had abdominal pain, 81 (83.5%) patients had nausea, 45 (46.4%) patients had excessive vomiting and 28 (28.9%) patients had diarrhea. Forty-seven (48.4%) patients had their aspartate aminotransferase (AST) elevated more than two fold of the Upper Normal Limit (UNL) level; 19 (20%) patients had their alanine aminotransferase (ALT) level elevated two fold higher than the UNL. Amylase was found to be two fold higher than the UNL only in 2 (2%) patients. Lipase level elevated two fold higher than the UNL in 11 (11.3%) patients. USG imaging showed that thickening of the gallbladder wall (over 3 mm) were observed in 83 (85.6%) patients. Endoscopic procedures showed erosive features particularly in the antrum, including edema of the gastric mucosa and widening of the gastric mucosa folding in four patients, while 4 (4.12%) patients had melena. Conclusion: Abdominal disturbances such as abdominal pain, vomiting, melena, liver enlargement and abnormal liver function as well as thickening of the gallbladder wall more than five mm are significantly high in patients with dengue hemorrhagic fever. Keywords: abdominal disturbances, plasma leakage, dengue hemorrhagic fever

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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