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Kelvin Setiawan

Department of Surgery, Tebet General Hospital, South Jakarta, Indonesia

Author-ID : 3756085

Health Professions Medicine & Pharmacology

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Fournier Gangrene in A 65 Years Old Obese Female with Uncontrolled Type II Diabetes Mellitus - A Case Report Rochella Krismurning Coffee; Kelvin Setiawan; Bramastha Aires Rosadi; Terry Renata Lawanto
JBN (Jurnal Bedah Nasional) Vol 4 No 1 (2020): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Background: Fournier gangrene is a disease with characteristic of rapidly progressive necrotizing fasciitis in the perianal and genitourinary area. Case: Usually it affects men, but we hereby present Fournier gangrene in an obese, diabetic, middle-aged woman. Her chief complaint was discomfort, swelling and foul odor coming from her genital area. Thus, she was diagnosed with Fournier gangrene and underwent emergency surgical debridement with local anaesthesia. After removing all necrotic tissues, overlying pus and debris, wounds were left open until granulation were seen and optimal condition of the tissue and planned for reconstructive surgery and additional debridement if needed. Local wound dressings were done with silver dressings and washed with 0.1% Polyaminopropyl biguanide solution. Patient received oral antibiotics daily for five days and visit surgery polyclinic twice a week for wound toilet and observation of wound condition. Conclusion: Early diagnosis, administration of broad-spectrum antibiotics and emergency debridement is important factors to successful outcome of Fournier gangrene.

Unilateral Usual Ductal Hyperplasia in A 22 Years Old Male Patient: A Case Report Kelvin Setiawan; Bramastha Aires Rosadi; Terry Renata Lawanto; Primariadewi Rustamadji
JBN (Jurnal Bedah Nasional) Vol 3 No 2 (2019): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Background: Benign breast disease have been broadly classified into non-proliferative lesions, proliferative lesions without atypia and hyperplasia with atypia. Proliferative disease, such as usual ductal hyperplasia, is associated with a 1.5 to 2 fold increased risk of developing invasive carcinoma. We reported a case of usual ductal hyperplasia in a young male. Case: A 22-year-old male complained of discomfort and enlargement of unilateral breast. Physical examination at that time revealed a palpable mass in the lateral upper quadrant of the patient’s left breast, three centimeters from nipple areola complex. The examination of axilla didn’t reveal any lymph node enlargement on both sides. His vital signs were normal without any abnormalities found on examination. Ultrasonography examination demonstrated fibroglandular tissue in the left breast with the volume of 11.13 cm3, consist of 4.8 cm length, 2.9 cm width and 0.8 cm depth. Excisional tumor biopsy was done on his left breast. Usual duct cell hyperplasia was present in microscopic examination with chronic inflammatory cells spreading around the fibrotic stromal cell. Physical examination, radiologic examination, and biopsy were all performed in this patient. Although the accuracy of the triple test is high, benign concordant results do not obviate further surveillance of a palpable mass. We advised our patient to routinely follow-up his condition every 6 months for 1 to 2 years, especially if there any changes found on his breasts. Conclusion: Any guidelines and further studies regarding patient’s follow-up examination after biopsy for male breasts tumor are needed in order of better understanding about this disease.

Co-Authors Bramastha Aires Rosadi Primariadewi Rustamadji Rochella Krismurning Coffee Terry Renata Lawanto

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