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Marcellus Simadibrata
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Medicine & Pharmacology

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Normal Histological Appearances of the Duodenum Jejunum and Terminal Ileum in Indonesian People Marcellus Simadibrata; Vera Yuwono; FJW Ten Kate; GNJ Tytgat; Laurentius Lesmana; Daldiyono Daldiyono; Iwan Ariawan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 8, ISSUE 3, December 2007
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/83200771-75

Abstract

Background: There is no literature specifically on the normal appearance of small bowel mucosa amongst Indonesians. Diseases of the small bowel can cause chronic diarrhea. Chronic diarrhea is common in Indonesia. Methods: Thirty seven patients with normal stomach and small bowel on endoscopic and histopathologic examination were included in this study. Biopsies were taken from the duodenal bulb, descending part of duodenum, jejunum and terminal ileum. The scoring Method for the inflammatory cells (lymphocytes, plasma cells and eosinophil cells) was carried out using the symbols 0 (negative), +, ++, and +++. Results: The mean height of the villi of the duodenal bulb was 265.00 ± 81.89 mm, the mean height of the crypts of the duodenal bulb was 196.67 ± 56.01 mm, the mean width of the villi were 59.14 ± 74.14 mm. The mean height of the villi of the duodenum pars descendens was 317.27 ± 99.66 mm and the mean height of the crypts was 218.79 ± 84.66 mm. The mean height of the villi of the jejunum was 341.76 ± 76.06 mm and the mean height of the crypts was 189.41 ± 58.15 mm. The mean height of the villi of the terminal ileum was 235.41 ± 73.32 mm, and the mean height of the crypts was 186.22 ± 64.09 mm. Conclusion: Histologically, the mean height of the villi of the normal small bowel was between 235.41 ± 73.32 to 341.76 ± 76.06 mm and the mean height of the crypts of the normal small bowel was between 186.22 ± 64.09 to 218.79 ± 84.66 mm. Keywords: normal, duodenum, jejunum, terminal ileum, histological appearances, villous height, villous width, crypt height
Diarrhea in HIV Infection Juferdy Kurniawan; Marcellus Simadibrata; Teguh Karyadi; Kie Chen
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, ISSUE 1, April 2009
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/101200923-28

Abstract

During the last decade, there has been an increase of immunocompromized patients all around the world; that mostly due to pandemic of Human Immunodeficiency Virus (HIV) infection. Chronic diarrhea as one of common symptoms in patients with HIV infection has different etiology compared to immunocompetent patients. Initial approach of diarrhea in HIV infection may be conducted by evaluating the temporal relationship between the development of diarrhea and the administration of antiretroviral, especially the protease inhibitor agents; which is then followed by fecal analysis/examination for pathogenic bacteria and protozoa as well as endoscopy examination. Biopsy examination of intestinal mucosa is necessary for HIV enteropathy or diarrhea due to microsporidia, which is confirmed further by electron microscopy. The etiology of chronic diarrhea in HIV patients may also different, depend on the cluster of differentiation count value of all patients. Based on such differences, it is necessary  to  have  adequate  approach,   recognition  and  understanding  in the management of chronic diarrhea, especially for HIV patients. Keywords: diarrhea, infection, HI
The Role of Biologics Agent in the Treatment of Inflammatory Bowel Disease Tri Hapsoro Guno; Marcellus Simadibrata
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 18, No 3 (2017): VOLUME 18, NUMBER 3, DECEMBER 2017
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (990.349 KB) | DOI: 10.24871/1832017184-196

Abstract

Inflammatory bowel disease (IBD), with major manifestations as Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic intestinal inflammatory disorder with an unknown etiology which pathogensis involving multifactorial immune disorder characterized by chronic relapsing inflammation of the intestine. Management of IBD depends on stage and location of the inflammation consist of the classic conventional treatment and the more new treatment with biologics agent. Biologics agent refers to monoclonal antibodies with activity directed against specific targets involved in the pathogenesis of chronic inflammatory conditions. Advances in the understanding of the specific mechanisms of pathogenesis IBD led to the development of targeted treatment. Today there are six biologics agent approved and used as therapy and there still many other biologics agent on research progress. Many reports show positive report about efficacy for the biological therapy compared with placebo and conventional treatment for the IBD. Limited by their cost and adverse effect that possibly happened, biologics agent is still promising therapy that change the course of IBD treatment.
Primary Gastrointestinal Tract Lymphoma David Reinhard Sumantri Samosir; Marcellus Simadibrata
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 1, April 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/111201040-43

Abstract

Extranodular lymphomacanbe found in almostallorgan. One third of the cases found in gastrointestinal(GI) tract, whichisthemost commonformofextranodular lymphoma.All thesubtypesof lymphomamayoccurasprimarylesionalongingastrointestinaltract,butthemostcommonformis B-celldiffuse largecelllymphoma.DiseasesthatlinkedwithGItractlymphomaareinflammatorybowel disease, celiac disease,Helicobacter pylori, virus infection,collagen diseaseandionicradiation.This reportdescribed a40yearsoldmanwith recurrentbloodystoolandcolon lymphomawasblamedas the sourceofbleeding withitsmanagementoflymphoma. Keywords:lymphoma, gastrointestinaltract,extranodular 
Colonic Tuberculosis and Chronic Diarrhea Tommy P Sibuea; Ari Fahrial Syam; Vera D Yoewono; Marcellus Simadibrata
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: 10.24871/22200129-31

Abstract

We describe that often colonic tuberculosis remains unsuspected prior to surgery. We therefore draw attention to pitfalls in the diagnosis and review the literature on the diagnostic modalities available to diagnose the disease. Today, the prompt diagnosis of an unknown gastroenteritis process involves colonoscopy. Using a fiberscope, a procedure with instantaneous return can be carried out. Patients with clinical presentation suggestive of colonic tuberculosis should have had either an aggressive diagnostic work out using high-yield tests or anti tuberculosis therapy.  Key words: Colonic tuberculosis, chronic diarrhea, colonoscopy
Dilatation Treatment for Esophageal Strictures Zakiah Zakiah; Ana Mira Lubis; Marcellus Simadibrata; Nurmiati Amir
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: 10.24871/93200898-102

Abstract

A patient with adjustment disorder and depression had experienced a suicide temptation by ingesting corrosive substance since 6 months before her hospital admission. On the first day care, she only can swallow “soft-fluid diet” which is given very slowly. Subsequently, the patient had a series of dilatation treatment guided by fluoroscopy and demonstrated a very impressive result. On the first dilatation, a 7 mm dilator was used, and then respectively 9, 10, 5, 12, 8 and 14 mm dilator was applied. We needed to perform three sessions of dilatation until the 9 mm dilator can be inserted. After the second dilatation, the patient had started to be able to eat refine porridge and subsequently rice porridge with soft vegetables and side dishes. At the end of treatment, she had already been able to eat normally. The general management of esophageal stricture by using dilator will be discussed in this article.   Keywords: stricture, corrosive substance, dilatation treatment, dysphagia
The Success Rate of ERCP for Identification and Stenting in Obstructive Jaundice in Cipto Mangunkusumo Hospital October 2004-July 2007 Simon Salim; Daniel Gunawan; Ilham Ahmadi; Marcellus Simadibrata; Achmad Fauzi; Ari Fahrial Syam
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 9, ISSUE 2, August 2008
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/92200845-47

Abstract

Background: Obstructive jaundice can be caused by malignant or benign origin. The treatment for these situations includes drainage by biliary stenting. The aim of this study was to evaluate the success rate of Endoscopic Retrograde Cholangiopancreatography (ERCP) in evaluating malignant obstructive jaundice and the success rate of plastic stent placement. Method: We conducted a retrospective study based on data of ERCP in Cipto Mangunkusumo hospital from October 2004 until July 2007. Results: We evaluated 100 patients who had undergone ERCP examination, 92 (92%) of them had clinical diagnosis of obstructive jaundice (direct bilirubin indirect bilirubin). Those with obstructive jaundice were found to have no malignancy in 47 (51.1%) patients, with malignancy in 28 (30.4%) patients, and 17 (18.5%) of them would have further diagnostic evaluation. We had conducted a descriptive study in 36 patients who had tried to have plastic stent placement. Nineteen (52.8%) patients succeed in plastic stent placement; whereas 17 (47.2%) patients had failed. Further evaluation showed that age and sex did not affect stent successfulness, and malignancy was showed to be a factor for stent failure (malignancy: 16 fail and 6 successes (27.3%) vs. non malignancy: 1 fail and 13 successes (92.85%). Conclusion: Cipto Mangunkusumo hospital has acceptable success rate for diagnostic ERCP in obstructive jaundice patients. However, it is relatively lower than other studies, which might be caused by late referral and different standard instruments that were used. Keywords: obstructive jaundice, malignancy, ERCP, stent placement
Hematochezia in Young Patient Due to Crohn’s Disease Anna Mira Lubis; Marcellus Simadibrata; Dadang Makmun; Ari F Syam
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 7, ISSUE 2, August 2006
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/72200654-56

Abstract

Crohn’s disease encompasses a spectrum of clinical and pathological patterns, affecting the gastrointestinal (GI) tract with potential systemic and extraintestinal complications. The disease can affect any age group, but the onset is most common in the second and third decade. Lower GI bleeding is one of its clinical features. Surgical intervention is required in up to two-thirds of patients to treat intractable hemorrhage, perforation, obstruction or unresponsive fulminant disease. We reported a case of Crohn’s disease in young male who suffered from severe lower GI bleeding (hematochezia) as the clinical features. Lower GI endoscopy revealed ulceration at the distal ileum surrounded by fibrotic tissue as a source of bleeding and a tumor mass at mesocolon. Upper GI endoscopy was unremarkable. Histopathologyc examination concluded multiple ulceration with chronic ischemic condition, appropriate to Crohn’s disease. The patient underwent emergency surgical intervention (subtotal colectomy and ileustomy), and his condition was improved.   Keywords: hematochezia, young male, Crohn’s disease, surgery
Approach for Diagnostic and Treatment of Achalasia Andree Kurniawan; Marcellus Simadibrata; Prima Yuriandro; Lie Khie Chen
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (431.146 KB) | DOI: 10.24871/1422013109-116

Abstract

Achalasia is a rare motor disorder of the esophagus and lower esophageal sphincter. The incidence is approximately 1/100,000 per year and the prevalence rate is 10/100,000. Achalasia is quite difficult to establishbecause the symptoms might be insidious and therefore not many people come to seek medical attention until it deteriorates to final stage of the disease. There are several modalities that can be used as diagnostic toolssuch as manometry, barium esophagogram, esophagoduodenoscopy, esophageal CT-scan, until the recent one, high-resolution manometry that can classify achalasia into three different types. The treatment options are the pharmacologic intervention, endoscopic treatment, minimal invasive surgery, and radical surgery.We reported a case of 20 year old female with achalasia who came with dysphagia symptom since three years before. The diagnosis was made by historytaking, physical examination and barium meal and esophagogastroduodenoscopy. The patient underwent pneumatic dilatation and since then the symptom was relieved.Keywords: achalasia, diagnostic, treatment
Obesity as a Risk Factor of Erosive Gastroesophageal Reflux Disease Hotmen Sijabat; Marcellus Simadibrata; Ari Fahrial Syam; Endang Susalit; Djulzasri Albar; Abdul Aziz Rani
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: 10.24871/112201061-65

Abstract

Background: Gastroesophageal reflux disease (GERD) is a pathological condition of esophagus caused by reflux of gastric content or gastric juice with multifactorial etiologies. Some complications may occur such as: ulcer, bleeding, stricture, Barret’s esophagus and esophageal adenocarcinoma. One of risk factors that currently taken into concern is obesity. Our study aimed to identify obesity and abdominal obesity as the risk factor in the development of erosive GERD and to recognize that abdominal obesity is more important factor compared to obesity itself as the risk factor on the incidence of erosive GERD.. Method: Our study was a cross-sectional study. Data was obtained from eligible patients at Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia between June and September 2009 Results: Samples were 74 patients with mean age of 48.61 ± 8.64 years. The proportion of female patients was larger than male (60.81% vs. 39.19%). The endoscopic assessment of upper gastrointestinal tract based on Los Angeles Classification included: Grade A esophagitis: 27.03%, Grade B: 16.21%, Grade C: 4.05%, Grade D: 1.35%. Obesity (odds ratio (OR) 17.160; 95% confidence interval (CI) 5.219 – 56.418, p = 0.000) and abdominal obesity (OR 10.371, 95% CI 3.260 – 32.915; p = 0.000) has been proven as risk factors in the development of erosive GERD. Conclusion: There is a correlation between obesity and abdominal obesity as risk factors on the development of erosive GERD. Obesity becomes a more important factor compared to abdominal obesity as the risk factor on the development of erosive GERD. Keywords: erosive gastroesophageal reflux disease, obesity, abdominal obesity, risk factor
Co-Authors Aan Santi Abdul Aziz Rani ACHMAD FAUZI Adang Bachtiar Adjeg Tarius Agi Satria Putranto Ahmad Fauzi Ahmad Soefyani Ali Imron Yusuf Ana Mira Lubis Andree Kurniawan Andri Sulaiman Angga Pramudita Anna Mira Lubis Ari F Syam Ari Fahrial Syam Arief Hakiki Armen Armen Arnold Hasahatan Harahap Arshita Auliana Arya Govinda Aziz Rani Badriul Hegar Bambang Sutopo Bona Adhista Bradley Jimmy Waleleng Budi Tan Oto Budiman Sudjatmika Ceva W. Pitoyo Chatarina Umbul Wahyuni Chudahman Manan Chudahman Manan Dadang Makmun Daldiyono Daldiyono Daldiyono Hardjodisasto Daldiyono Hardjodisastro Daniel Gunawan Dasril Nizam David Reinhard Sumantri Samosir Deddy Gunawanjati Dharmika Djojoningrat Diah Rini Handjari Diana Aulia Diany N Taher Dicky Levenus Tahapary Didi Kurniadhi Djulzasri Albar Dolly Dolven Kansera Drupadi Harnopidjati Singh Dillon Dyah Ratna Budiani Ekowati Rahajeng Elizabeth Merry Wintery Elli Arsita Endang Susalit Ening Krisnuhoni Epistel Pangujian Simatupang FJW Ten Kate Fransiska Hardi Gerie Amarendra GNJ Tytgat Guntur Darmawan Haryanto Surya Helsi Helsi Herdiman T Pohan Hery Djagat Purnomo Hotmen Sijabat Ilham Ahmadi Ina Susianti Timan Ina Sutanto Timan Indah S. Widyahening Indra Marki Irfan Maulani Irsan Hasan Iskandar A Ivo Novita Sah Bandar Iwan Ariawan Jacobus Albertus Jane Estherina Jeffri Gunawan Jeffry Beta Tenggara Joseph JY Sung Juferdy Kurniawan Julwan Pribadi Kaka Renaldi Katharina Setyawati Kharia Utia Khie Chen Kie Chen L A Lesmana Laurentius Lesmana Lianda Siregar Lies Luthariana Loli J Simanjuntak Lusy Erawati Lydia D Simatupang M Purnomo Isnaeni Moch Ikhsan Mokoagow Murdani Abdulah Murdani Abdullah Nata Pratama Nisan Soeheri Noto Dwimartutie Novie Rahmawati Zirta Nur Rasyid Nurmiati Amir Pamela Abineno Parlindungan Siregar Paulus Kusnanto Paulus Simadibrata Poerniati Koes Andrijani Prima Yuriandro Rabbinu Rangga Pribadi Raden Nur Ista Ralph Girson Gunarsa Ratu Ratih Kusumayanti Riadi Wirawan Riahdo Saragih Rino A Gani Rino Alvani Gani Rizki Yaruntradhani Rolan Sitompul Rudolf Simadibrata Rudy Hidayat Ryan Ranitya Salius Silih Sedijono Sedijono Seri Mei Maya Ulina Simon Salim Siti Setiati Steven Sumantri Suryantini Suryantini Suzana Ndraha Suzanna Ndraha Syarif Hidayat Syarif Hidayat T Yuli Pramana Teguh Karyadi Tengku Riza Zarzani N Tjahjadi Robert Tedjasaputra Toman L Toruan Tommy P Sibuea Tony Loho Tri Hapsoro Guno Tri Juli Edi T Unggul Budihusodo Vera D Yoewono Vera Yuwono