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Marcellus Simadibrata
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Medicine & Pharmacology

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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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (582.439 KB) | DOI: 10.24871/1232011140-145

Abstract

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
Detection Of Helicobacter Pylori Infection With Stool Antigen: Comparison With Other Techniques Paulus Simadibrata; Rudolf Simadibrata; Marcellus Simadibrata
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 3, NUMBER 2, August 2002
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/32200246-49

Abstract

Helicobacter pylori has been known as a cause of chronic gastritis, a predisposition to gastric and duocenal ulcers, and a class I gastric carcinogen. Throughout the world, H. pylori infection is very common, reaching 40% -50% of the population in developed nations and 80% – 90% of the population in developing nations. Several techniques have been used to detect H. pylori infection, such as the urea breath test, rapid urease test, serological test, as well as biopsies of gastric or duodenal tissues for culture and histopathology. In this review article, we will discuss a relatively new method to detect H. pylori antigen in stools with enzyme immunoassay, and comparisons with other standard techniques. However, the H. pylori stool antigen test is not yet commercially available in Indonesia.   Key words: Helicobacter pylori - stool antigen - enzyme immunoassay.
Peutz Jeghers Syndrome M Purnomo Isnaeni; Marcellus Simadibrata; Murdani Abdullah; Ari Fahrial Syam; Achmad Fauzi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 7, ISSUE 3, December 2006
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/73200682-85

Abstract

Peutz-Jeghers Syndrome (PJS) is a rare condition that tends to run in families. Diagnosis of PJS is made if a person has polyps in the gastrointestinal (GI) tract and at least two of the following: polyps in the small bowel, melanin spots, and/or a family history of PJS. The typical clinical manifestation of the disease is associated with complications secondary to intestinal polyps often requiring surgical treatment. A young woman, 29 years old with PJS had been hospitalized in Cipto Mangunkusumo hospital. She was suffering from GI complication secondary to her polyps such as abdominal pain, nausea, vomited every time she takes her meal and milk, anorexia, fatigue, weakness, chronic diarrhea with hematoschezia. Upper and lower endoscopy showed the multiple polyps along from esophagus, gaster, duodenum, and her colon. Histopathology examination confirmed the type of polyps is Peutz Jeghers with the unique morphology consisting of mucosa with interdigitating smooth muscle bundles that yield a characteristic branching tree appearance. We also found the family tree of this patient and it is a good evident how PJS can be inherited in a family. Keywords: Peutz-Jeghers syndrome, melanin spots, polypsry
Gastroesophageal Reflux Disease in Obesity Hotmen Sijabat; Marcellus Simadibrata; Murdani Abdullah; Ari Fahrial Syam
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 9, ISSUE 1, April 2008
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/91200810-15

Abstract

Incidence of gastroesophageal reflux disease (GERD) has been significantly increased, and nearly 25% of the population has experienced GERD. It appears to be correlated to an increasing number of obesity in the population (BMI 30 kg/m2). Mechanism of the GERD is affected by multifactor. Increased intra-abdominal pressure is considered as one of risk factors for GERD. The development of GERD is virtually associated with a down turning of lower esophageal sphincter tonus, increased transient lower esophagus sphincter relaxation (TLESR), and decreased capacity of esophageal clearance. Management of GERD in obesity includes weight loss treatment, pharmacotherapy by using prokinetics, H2 -receptor antagonists, proton pump inhibitor and surgical approach including fundoplication, gastric banding and vertical banded gastroplasty. Keywords: GERD, obesity, BMI, TLESR, weight loss, abdominal pressure
Pancreatic Exocrine Insufficiency in Chronic Diarrhea Marcellus Simadibrata; Daldiyono Hardjodisastro; Abdul Aziz Rani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 6, ISSUE 1, April 2005
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/6120054-9

Abstract

Background: One of the causes of chronic diarrhea is pancreatic exocrine insufficiency. Chronic diarrhea cases are commonly encountered in Indonesia. Materials methods: All patients with chronic diarrhea at hospitals in Jakarta were included in this study and dyspeptic patients were used as control subjects. The study and control subjects must submit their stool for fecal pancreatic elastase-1 examination at a private laboratory in Jakarta. Mild/moderate pancreatic exocrine insufficiency was defined if the concentration was between 100 - 200 mg E1/g stool. Severe pancreatic exocrine insufficiency was defined if the concentration was below 100 mg E1/g stool. The data was analyzed using Fisher or Kruskal-Wallis tests. Results: There were 32 chronic diarrhea patients with a male to female ratio of 19/13 (59.38%/40.62%). The most frequent age range was 50-59 years old (39.5%). The characteristics (sex, age and race) of chronic diarrhea patients were matched with the characteristics of dyspeptic patients as control subjects (p 0.05). The fecal elastase-1 results in chronic diarrhea displayed greater pancreatic exocrine insufficiency ( 200 mg E1/g stool) than in dyspepsia (control) ( 200 mg E1/g stool, p 0.001). The mean fecal elastase-1 Result in chronic diarrhea and in dyspepsia were 316.29 + 195.44 vs. 475.93 + 65.33 mg E1/g stool (p 0.001). Six patients (18.74%) were established as having severe pancreatic exocrine insufficiency. Seven patients (21.88%) were found with mild/moderate pancreatic exocrine insufficiency. Conclusion: Pancreatic exocrine insufficiency was found frequently in chronic diarrhea Keywords: pancreatic exocrine insufficiency, chronic diarrhea, fecal pancreatic elastase-1
The Role of Fecal Occult Blood Test in Screening of Colorectal Cancer and Inflammatory Bowel Disease 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: 10.24871/111201035-39

Abstract

Colorectal cancer (CRC) and inflammatory bowel disease (IBD) are a quite common colon disease in the world. The World Gastroenterology Organization (WGO) recommends screening test to detect colorectal cancer, i.e. fecal occult blood test (FOBT) and colonoscopy. Diagnosis of CRC is established based on a good history taking, clinical manifestation, physical examination and laboratory examination. Other supporting laboratory tests include routine laboratory test of hemoglobin for detecting anemia, examination of bleeding stool either macroscopically or microscopically. Radiographic examination, either colon in loop or colonoscopy (if such modalities are available), shall be performed to confirm the occurrence of cancer mass in the colon. Moreover, biopsy examination is carried out to obtain the histopathological feature of tumor mass or the type of cancers. WGO has made a guideline for CRC screening, which consists of 6 cascades, which depend on the risk of colorectal cancer and local facilities available. There are several kinds of FOBT, but the most frequently used include three methods, i.e.: the FOBT guaiac base/traditional, the fecal immunochemical test (FIT) and the FOB + transferrin rapid test (OT 102c OT 103c). FIT and FOB + transferrin rapid test have a quite high sensitivity and specificity in detecting the lower gastrointestinal tract bleeding caused by colorectal cancer and IBD. Keywords: FOBT, colorectal cancer, IBD
Pancreatic Pseudocyst with Colonic Perforation Complication Angga Pramudita; Marcellus Simadibrata; Achmad Fauzi; Nisan Soeheri
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 1, April 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/121201164-69

Abstract

Pancreatic pseudocyst is one of complications of both acute and chronic pancreatitis. It is a rare clinical condition. The incidence is low ranging between 1.6 and 4.5%, or 0.5-1 per 100,000 adults annually. The clinical manifestations range from asymptomatic to severe acute abdomen due to complications. Acute complications may include bleeding, infection, rupture and perforation of the gastrointestinal tract; while chronic complications are gastric and biliary obstruction as well as thrombosis of portal vein. We present a case report of a 38-year-old male with complaints of abdominal pain, fatigue, nausea and vomiting containing undigested food and yellow liquid. On clilnical examination, the patient was found to be fatigue, having enlarged abdomen, unpalpable liver and spleen, no signs of shifting dullness was detected. We found an abdominal mass in the left upper and lower quadrant sized 20 x 10 cm accompanied with epigastric pain on palpation. Abdominal ultrasonography revealed a cystic lesion on the head of pancreas with differential diagnosis of pseudocyst. The abdominal computed tomography (CT-scan) showed a lesion arising from pancreas, extending into abdominal cavity and part of left groint and attaching to left intestinal in the abdomen, part of gastric region and left diaphragm. A diagnosis of pancreatitis was suspected with differential diagnosis of pancreatic mass and peritonitis. It is a case report of pancreatic pseudocyst with acute complication of colonic perforation. Keywords: pseudocyst, pancreatitis, pancreatitis complication, colonic perforation
Colorectal Cancer Metastasis of and the Risk Factors Ahmad Soefyani; Abdul Aziz Rani; Marcellus Simadibrata; Murdani Abdullah; Ening Krisnuhoni
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: 10.24871/11120107-10

Abstract

Background: Colorectal cancer (CRC) is the fourth most prevalent cancer in the world and is positioned the second most common cancer in the United States. Patients with CRC in Indonesia showed a greater proportion. In Jakarta, 47.85% of CRC cases occur under the age of 45 years. The purpose of this study is to determine metastasis and the factors that influence colorectal cancer patients. Method: This study was conducted retrospectively from January 2003-December 2007 in Cipto Mangunkusumo hospital. Patients are eligible if they underwent colonoscopy, tumor biopsy, anatomical pathology, abdominal CT scan, abdominal ultrasonography, and radiology procedures. Result: Of all 1,615 patients who underwent colonoscopy procedure, 377 patients were diagnosed with colorectal cancer. Subject that met the criteria consist of 86 patients, where 56 (65.1%) male. Most aged 51-60 years old (26.7%), mean age 47.90 ± 14.53 years old. The tumor is most commonly located in the rectum and sigmoid 40 (46.5%), in which 18 (45%) among them had metastasized. Compared with male patients, female patients experienced more metastases, but not statistically significant. Among the patients with metastasized CRC, 42.3% of them 40 years old, 37.2% patients 41-60 years old, and 29.4% patients 60 years old. Well-differentiated CRC produce larger number of metastatic cases than poorly-differentiated CRC. Poorly-differentiated CRC tend to produce adjacent metastasis, and also happened in relatively young age in compared with well-differentiated cancer. Conclusion: There was significant correlation between younger age group with a poor degree of histopathologic differentiation. Patients with CRC consist of more male patients than female ones. Factors sex, age group, histopathologic subtypes, and tumor location was not associated with metastasis. Keywords: colorectal cancer, metastasis, well-differentiated, poorly-differentiated
Chronic Diarrhea Due to Intestinal Amyloidosis Lydia D Simatupang; Kharia Utia; Ari Fahrial Syam; Marcellus Simadibrata; Arya Govinda; Ening Krisnuhoni
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: 10.24871/63200591-94

Abstract

Amyloidosis is a rare disease, when diagnosed it’s incurable and mostly affect over 40 years old male. Diagnostic is confirmed if histopathologic stained positive with Congo red and evidence of monoclonal protein. Survivals for untreated patients are 13 months in primary amyloidosis but if secondary to other chronic disease and systemic, survival could be 3-4 years. It can not be prevented but when affected, control of the underlying illness can prevent progression of amyloidosis. We report a rare case of a 67 year old male, who came with chronic diarrhea. The stool analysis, there were no negative gram microorganisme found, only food maldigestion and fungus infection. Stool analyze from parasitology department were found microspore, but the stool culture were sterile. The patient underwent colonoscopy which revealed hyperemis mucosa in rectum, sigmoid, descending transverse colon. From the biopsy was concluded intestinal amyloidosis. We treated the patient symptomatically and couldn’t find the underlying inflammatory disease which causes the problem. Keywords:  secondary  amyloidosis,  chronic  diarrhea, malabsorption,  colonoscopy,  protein electrophoresis
Non-Invasive Assessment and Evaluation of Portal Hypertension in Patients with Liver Cirrhosis Indra Marki; Rino Alvani Gani; Marcellus Simadibrata; Chudahman Manan
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: 10.24871/22200121-28

Abstract

Ultrasonography examination is an one of examination that can be used to see the abnormality of portal vein system. The technology of ultrasonography examination has further developed especially after using of Doppler ultrasonography which could portray haemodynamic changes from portal vein in liver cirrhosis patient. From this examination we also could predict bleeding.    Keywords: liver cirrhosis, portal hypertension, doppler ultrasonography
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