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Isaac A. Deswanto, Isaac A.
Department of Surgery, Tarakan General Hospital, Tarakan, North Kalimantan
Medicine & Pharmacology

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Annular pancreas: the failure of side-to-side gastrojejunostomy anastomosis and the success of repair with Roux-en-Y gastrojejunostomy Deswanto, Isaac A.; Barus, Janta F.
Medical Journal of Indonesia Vol 24, No 2 (2015): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (478.446 KB) | DOI: 10.13181/mji.v24i2.1207

Abstract

Annular pancreas is a rare congenital anomaly characterized by a partial or complete encirclement of ectopic pancreas tissue around the duodenum. We report a case of annular pancreas in a 15 day-old infant admitted to the hospital with complaints of profuse and recurrent vomiting and loss of body weight. Non-contrast abdominal X-ray showed a dilated stomach with bubbles formation around the upper abdomen. An obstruction was noted and open laparotomy was performed. Upon laparotomy, pancreatic ring encircled the proximal duodenum causing an obstruction. Side-to-side gastrojejunostomy was performed and passage through the bypass was satisfactory. Four days after the operation, vomiting and bulging abdomen ensued. Contrast abdominal X-ray demonstrated filling defects at the level of obstruction and the anastomosis made. Anastomotic stricture was suspected and thus was corrected using Roux-en-Ygastrojejunostomy procedure. Postoperative course in this patient was satisfactory and patient was discharged after 24 days of hospitalization.
Management of bladder stones: the move towards non-invasive treatment Deswanto, Isaac A.; Basukarno, Ari; Birowo, Ponco; Rasyid, Nur
Medical Journal of Indonesia Vol 26, No 2 (2017): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (386.882 KB) | DOI: 10.13181/mji.v26i2.1602

Abstract

Background: Bladder stone accounts for 5% of all cases of urolithiasis. Bladder stones management has evolved over the last decades from open bladder surgery (sectio alta) to intracorporeal cystholithotripsy as well as extracorporeal shock wave lithotripsy (ESWL). ESWL presents to be a promising modality in the management of bladder calculi due to its simplicity and well tolerability. This study is thus conducted to present data on the safety and effectiveness of ESWL in the management of bladder stone patients.Methods: This is a retrospective study evaluating the medical records of 92 bladder calculi patients admitted to Cipto Mangunkusumo General Hospital (RSCM) from January 2011 to April 2015. Patient’s age, gender, type of stone and procedure being done, status of stone disintegration, length of hospital stay, and any complications that may occur are noted down and statistically analyzed using SPSS v. 20.Results: Majority of the patients underwent ESWL (49 out of 92, 53.3%). The stone free rates for ESWL, intracorporeal lithotripsy, and sectio alta are 93.9%, 97.0% and 100% respectively. One patient had to repeat ESWL. The ESWL group had the smallest stone size average compared to the intracorporeal lithotripsy and section alta group (2.5 cm±2.0 cm vs 4.8 cm±3.7 cm vs 7.4 cm±5.4 cm respectively). The ESWL sessions were conducted in the outpatient clinic, and thus no hospital stay was required.Conclusion: ESWL can be suggested as an effective non-invasive approach in the disintegration of bladder stone of ≤25 mm with a promisingly high stone-free rate (93.9%) Furthermore, ESWL can be performed on an outpatient basis with minimal complications.
Co-Authors Ari Basukarno, Ari Janta F. Barus, Janta F. Nur Rasyid Ponco Birowo