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Analisis Rasio Neutrofil Limfosit pada Pasien Carcinoma Mammae dengan Risiko Kejadian Efusi Pleura Lolongan, Gerald Randy; Tangkilisan, Adrian; Sukanto, Wega; Langi, Fima Lanra Fredrik G.
Syifa'Medika Vol 16, No 1 (2025): Syifa Medika : Jurnal Kedokteran dan Kesehatan
Publisher : Faculty of Medicine

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32502/sm.v16i1.9839

Abstract

Breast cancer is one of the most common cancers, with complications such as pleural effusion potentially worsening patient prognosis. This study aims to analyze the relationship between the neutrophil-lymphocyte ratio (NLR) and pleural effusion occurrence in breast cancer patients at RSUP Prof Dr. R.D. Kandou Manado. The study used a cross-sectional retrospective design, involving 196 breast cancer patients divided into two groups: those with and without pleural effusion. The results showed that while there is a tendency for higher NLR in patients with pleural effusion, other factors like cancer stage and supraclavicular lymph node enlargement play a more dominant role in predicting pleural effusion. NLR was not found to be a strong biomarker for independently predicting pleural effusion. This study provides insights into the potential of NLR for predicting complications in breast cancer patients, but further research is needed to identify more sensitive biomarkers for pleural effusion prediction.
Faktor Prediktor Terjadinya Delayed Hemothorax pada Pasien dengan Riwayat Trauma Tumpul Toraks di RSUP Prof Dr. R.D. Kandou Manado Stefanus, Gufi George; Sukanto, Wega; Tangkilisan, Adrian; Langi, F. L. Fredrik G.; Prasetyo, Eko; Tamburian, Christha; Saleh, Denny
Jurnal Sehat Indonesia (JUSINDO) Vol. 6 No. 02 (2024): Jurnal Sehat Indonesia (JUSINDO)
Publisher : CV. Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/jsi.v6i02.133

Abstract

Trauma toraks merupakan penyebab signifikan dari morbiditas dan mortalitas, terutama dalam konteks multitrauma, dengan dampak kematian berkisar antara 20% hingga 25%. Penelitian ini bertujuan untuk mengetahui faktor prediktor terjadinya delayed hemothorax pada pasien dengan riwayat trauma tumpul toraks di RSUP Prof. Dr. R.D. Kandou Manado. Metode yang di guanakan metode penelitian dengan pendekatan kohort retrospektif, dengan cara consecutive sampling, analisis data dengan analisis deskriptif. Adapun hasil penelitian, ditemukan bahwa faktor prediktor yang signifikan adalah adanya fraktur tulang iga, jumlah fraktur iga 3 atau lebih, dan lokasi fraktur tulang iga. Usia dan kejadian kontusio paru tidak ditemukan sebagai faktor prediktor yang signifikan. Hasil penelitian juga menunjukkan bahwa pasien yang memiliki fraktur pada tulang iga ke 10-12, 6-9, dan 3-5 memiliki risiko lebih tinggi untuk mengalami delayed hemothorax.
EFFUSIVE CONSTRICTIVE PERICARDITIS: HOW TO DIFFERENTIATE WITH CARDIAC TAMPONADE Sukanto, Wega; Tangkilisan, Adrian; Tamburian, Christa; Stefanus, Gufi George
Jurnal Impresi Indonesia Vol. 2 No. 10 (2023): Jurnal Impresi Indonesia
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/jii.v2i10.3766

Abstract

Constrictive-effusive pericarditis (ECP) is a rare syndrome but is gaining increasing attention in the classification of pericardial diseases. The aim of this research is to identify the differences in clinical symptoms between constrictive pericardial effusion and cardiac tamponade, such as chest pain, shortness of breath, blood pressure, heart rate, and other symptoms. We report the case of a 67-year-old man who had exertional dyspnea, lack of energy, fatigue, and pleuritic chest pain for the past 6 months. X-rays showed pericardial effusion and pericardial thickening with calcification indicating constrictive pericarditis. Echocardiographic examination also revealed similar findings. The patient then underwent pericardiectomy, during which the pericardial effusion was evacuated. However, after this procedure, cardiac contractions were still limited, underlying the constrictive process. This case illustrates the complexity in differentiating constrictive pericarditis from cardiac tamponade and the importance of accurate diagnosis in the management of this pericardial disease. In this case report, we discuss the clinical findings, diagnostic measures, and management implications in a patient with overt constrictive pericarditis.
Partial Intestinal Obstruction Caused by Left Diaphragmatic Hernia: A Case Report Pirade, Audi; Paat, Rigel K.; Tangkilisan, Adrian
e-CliniC Vol. 14 No. 1 (2026): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v14i1.65769

Abstract

Abstract: Diaphragmatic hernia in adults is a rare but potentially serious condition that often presents with non-specific gastrointestinal and respiratory symptoms. This case highlights a left-sided diaphragmatic hernia complicated by partial intestinal obstruction. We reported a 54-year-old male presented with a one-week history of progressive abdominal bloating and intermittent abdominal pain, accompanied by nausea but no vomiting or fever. Bowel movements and flatus were present. In examination, he was hemodynamically stable with abdominal distension and positive bowel sounds. Nasogastric tube drainage produced greenish fluid. Digital rectal examination showed normal stool without blood or mucus. Chest X-ray suggested a left diaphragmatic hernia, and abdominal X-ray revealed partial bowel obstruction without signs of pneumoperitoneum. Laboratory findings were within normal limits, except for mild hypokalemia (K⁺ 3.3 mmol/L). A diagnosis of partial mechanical intestinal obstruction due to a left diaphragmatic hernia was made. The patient underwent an urgent non-contrast abdominal CT followed by combined laparotomy and thoracotomy. Intraoperatively, a diaphragmatic defect (3×3 cm and 10×10 cm) with adhesions between the left lung and diaphragm was identified. Adhesiolysis was performed, and the defect was repaired using non-absorbable sutures, followed by diaphragmatic plication and chest tube insertion. In conclusion, this case underscores the importance of including diaphragmatic hernia in the differential diagnosis of adult patients with persistent abdominal symptoms. Timely imaging and a multidisciplinary surgical approach enabled resolution of obstruction and definitive repair, preventing serious complications. In conclusion, early recognition and appropriate surgical management are key to optimizing outcomes in adult diaphragmatic hernia with bowel involvement. Keywords: diaphragmatic hernia; intestinal obstruction
Delayed Onset of Pseudoaneurysm in Brachial Stab Wound Trauma: A Case Report Tangkilisan, Adrian; Sukanto, Wega; Tamburian, Christha Z.; Paat, Rigel K.; Pontoh, Pramijaya R.
Medical Scope Journal Vol. 8 No. 2 (2026): MEDICAL SCOPE JOURNAL
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v8i2.64553

Abstract

Abstract: Pseudoaneurysms of the extremity are rare and may present acutely or subacutely. Very rarely, the presence of thromboembolism in the aneurysm can result in terminal ischemia, gangrene, and amputation. Only early diagnosis and treatment can prevent progression to significant disability. This case report described a 36-year-old male referred to the hospital with a complaint of a lump in the upper left arm for two months before admission. The patient reported a history of being punctured by a nail, and one week later, an enlarging lump appeared. The patient also complained of a lump on the right chin for one month before hospital admission. The patient was then diagnosed with an impending rupture of the left brachial pseudoaneurysm due to a puncture wound in the left brachial and was scheduled for arterial repair. Although the diagnosis and treatment of the patient were delayed for two months and treated surgically, no immediate or late complications were seen. This case underscores the crucial role of timely diagnosis and surgical treatment, as upper extremity aneurysms can cause severe decreases in function and lead to the loss of an arm or fingers. The successful surgical reconstruction in this case is a motivating example of the preferred treatment for such patients. Keywords:  pseudoaneurysm; brachial artery; repair artery; delayed onset