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Delfican Delfican
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PENYAKIT PERLEMAKAN HATI NON ALKOHOLIK PADA ANAK Yusri Dianne Jurnalis; Delfican Delfican; Yorva Sayoeti
Majalah Kedokteran Andalas Vol 36, No 2 (2012): Published in August 2012
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (551.082 KB) | DOI: 10.22338/mka.v36.i2.p121-131.2012

Abstract

AbstrakPenyakit perlemakan hati nonalkoholik (NAFLD) ditandai dengan penumpukan lemak di hati pada penderita yang tidak mengkonsumsi alkohol sebelumnya, meliputi steatosis sederhana dan steatohepatitis nonalkoholik (NASH). NAFLD/NASH merupakan manifestasi hepatik dari sindrom metabolik. Prevalensi NAFLD pada anak mengalami peningkatan seiring dengan meningkatnya prevalensi obesitas pada anak. Kelainan ini berhubungan dengan umur, jenis kelamin dan ras. Patogenesisnya diterangkan melalui hipotesis “dua pukulan”. Selain manifestasi klinis, laboratorium dan pencitraan, biopsi hati merupakan baku emas dalam menegakkan diagnosis. Melalui biopsi hati dapat dinilai derajat nekroinflamatori yang terjadi serta fibrosis pada NASH. Terdapat 2 jenis steatohepatitis dengan tipe 2 ditemukan pada 51% penderita NAFLD anak. Walaupun telah dilakukan uji klinis terhadap beberapa obat, namun modifikasi gaya hidup, pola makan dan kebiasaan berolahraga merupakan tatalaksana yang banyak diterapkan saat ini.Kata kunci : penyakit perlemakan hati nonalkoholik, steatohepatits nonalkoholik, obesitasAbstractNonalcoholic fatty liver disease (NAFLD) is a disease in which excessive fat accumulates in the liver without a history of alcohol abuse. This disease includes simple steatosis and nonalcoholic steatohepatitis (NASH). NAFLD/NASH is recognized as a hepatic manifestation of metabolic syndrome. In recent years, pediatric NAFLD has increased in line with the increased prevalence of pediatric obesity. It is associated with sex, age and ethnicity. The “two-hit” hypothesis is widely accepted as the pathogenesis. Although clinical symptoms, laboratory data and imaging findings are important, liver biopsy is regarded as the gold standard of the diagnosis. It is essential for assessing the degree of necro-inflammatory change and fibrosis in NASH. Two different types of steatohepatitis have been reported, with type 2 NASH being present in as many as 51% of pediatric NAFLD patients. Although pharmacotherapy has been studied in clinical trials, lifestyle modification by diet and exercise remains the mainstay of treatment for NAFLD/NASH.Key word : nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, obesity
ABSES HATI PIOGENIK Yusri Dianne Jurnalis; Delfican Delfican; Yorva Sayoeti
Majalah Kedokteran Andalas Vol 36, No 1 (2012): Published in April 2012
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (342.543 KB) | DOI: 10.22338/mka.v36.i1.p106-112.2012

Abstract

AbstrakAbses hati piogenik merupakan suatu kondisi yang berat dan mengancam kehidupan dengan angka mortalitas yang tinggi sehingga membutuhkan diagnostik dan terapi yang akurat. Gejala yang paling sering ditemukan adalah nyeri perut bagian atas, hepatomegali, demam tinggi, mual dan muntah. Gejala ini bervariasi sesuai ukuran abses, keadaan umum pasien, adanya penyakit dasar dan komplikasi. Pada sebagian besar kasus, penyakit dasarnya tidak diketahui. Abses biasanya soliter dan terletak di lobus kanan hati. USG dan CT scan abdomen merupakan sarana diagnostik utama. Abses hati piogenik diterapi dengan aspirasi perkutaneus bersamaan dengan antibiotik. Jika gagal, drainase dengan pembedahan dibutuhkan. Dengan adanya terapi invasif yang minimal seperti aspirasi jarum perkutaneus atau drainase kateter yang dipandu secara radiologis serta ketersediaan antibiotik berspektrum luas, pasien jarang membutuhkan tindakan pembedahan saat ini.Kata kunci : abses hati piogenik, aspirasi perkutaneus, drainase bedahAbstractPyogenic liver abscess (PLA) is a serious, life threatening condition with a high mortality rate that represents a diagnostic and therapeutic challenge. The most common presenting clinical symptoms are upper abdominal pain, tenderness, hepatomegaly, high-grade fever, nausea and vomiting. These features are variable depending upon the size of the abscess, general health of the patient, associated diseases and complications. In majority of the cases, the underlying cause could not be identified. Majority of abscesses are solitary and are noted in the right lobe of liver. USG and CT of the abdomen are the main tools of diagnosis. PLAs are mainly treated by percutaneous aspiration under antibiotic cover. If fails, surgical drainage becomes necessary. However, with the advent of minimally invasive therapy such as image-guided percutaneous needle aspiration or catheter drainage and the availability of broadspectrum antibiotics, patients with PLA nowadays seldom require open surgery for treatment.Key word : pyogenic liver abscess, percutaneous aspiration, surgical drainage
Co-Authors Yorva Sayoeti Yusri Dianne Jurnalis