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All Journal Damianus Journal of Medicine Indonesian Journal of Cancer The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Sudoyo, Aru Wisaksono
Division Of Hematology And Medical Oncology, Department Of Internal Medicine, Faculty Of Medicine, University Of Indonesia/Dr. Cipto Mangunkusumo General National Hospital
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Treatment Options of Lemmel’s Syndrome: A Case of Benign Obstructive Jaundice in The Elderly Abigail Prasetyaningtyas; Perdana Aditya Rahman; Aru Wisaksono Sudoyo; Achmad Fauzi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 16, No 2 (2015): VOLUME 16, NUMBER 2, August 2015
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (193.888 KB) | DOI: 10.24871/1622015120-125

Abstract

Lemmel’s syndrome, also known as duodenal diverticulum obstructive jaundice,  is a rare cause of benign obstructive jaundice that should be included in the differential diagnosis of biliary obstruction when PAD is present, in the absence of cholelithiasis or other detectable obstacle. Diagnosing Lemmel’s syndrome could be challenging, but being aware of this condition is important to avoid mismanagement and it begins with identification of PAD, while interpreting any bile duct imaging. It can be misinterpreted as periampullary tumors, biliary stones, or pancreatic pseudocyst. Symptomatic patients can be successfully managed endoscopically in many cases but surgical management would be necessary in selected cases.We present a patient with benign obstructive jaundice caused by Lemmel’s syndrome who was successfully treated with endoscopic sphicterectomy. A 67 years old female presented to the emergency department with chief complaint of jaundice. The patient was assesed to have obstructive jaundice cause by a duodenal mass, elevation of transaminase enzime supected caused by drug induced liver injury, hypertension (controlled), and anterior extensive coronary ischemia. Endoscopic retrograde cholangiopancreatografi (ERCP) showing mutiple giant diverticle in second part of duodenum, stenosis of the distal CBD with compression of diverticular extra luminal as a differential diagnosis. Endoscopic ultrasound (EUS) was performed to exlude a periampullary tumor, resulting distal CBD stenosis due to compression of multiple periampullary diverticula (PAD). We performed an endoscopic sphinterectomy (EST) and the stent was removed. A further evaluation of the tuberculous lymphadenitis was planned as outpatient setting. One month follow-up, no recurence of jaundice was observed.
Biopsi cair pada kanker kolorektal: Harapan dan tantangan Angka, Rebecca Noerjani; Lumban Tobing, Demak; Sudoyo, Aru Wisaksono; Siregar, Nurjati Chairani; Jeo, Wifanto Saditya
Bahasa Indonesia Vol 21 No 3 (2022): Damianus Journal of Medicine
Publisher : Atma Jaya Catholic University of Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25170/djm.v21i3.3575

Abstract

Pendahuluan: Global Cancer Statistics 2020 menunjukkan angka kejadian kanker kolorektal menduduki peringkat ketiga dengan urutan kedua angka kematian. Pemeriksaan biopsi cair pada kanker kolorektal mulai dilakukan untuk mempelajari sel-sel tumor yang ada di dalam sirkulasi yaitu circulating tumor cells (CTCs) dan cell-free circulating tumor DNA (ctDNA/cfDNA). Tujuan dari penulisan artikel ini adalah untuk menemukan dan menelaah penelitian-penelitian yang telah dilakukan mengenai biopsi cair baik dari sisi metode, hasil maupun manfaat klinik pada kanker kolorektal. Metode: Metode pencarian literatur dilakukan melalui Embase, Scopus dan PubMed. Dari 143 artikel yang ditemukan saat pencarian awal, setelah melalui tahap seleksi akhir ditentukan 15 artikel yang memenuhi kriteria inklusi. Hasil: Biopsi cair dapat digunakan untuk mendeteksi mutasi yang tidak ditemukan pada tumor primer pasien kanker kolorektal serta analisis kombinasi circulating cell-free DNA (ccfDNA) dan ctcDNA dapat meningkatkan jumlah mutasi yang terdeteksi. Analisis ctDNA dalam plasma yang dikumpulkan secara serial, memungkinkan mendeteksi ctDNA mutan yang muncul, sehingga dapat digunakan untuk memantau perkembangan penyakit pasien serta menemukan mekanisme resistensi. Pengambilan sampel pasien secara serial menunjukkan bahwa penurunan metilasi terjadi pada pasien yang berespon baik terhadap pengobatan, baik operasi maupun kemoterapi. Sebaliknya pasien yang tidak diobati atau mengalami kekambuhan menunjukkan peningkatan metilasi. Status MSI pada kanker kolorektal yang terdeteksi melalui cfDNA relatif konsisten dengan yang ada di sampel jaringan tumor. Simpulan: Keuntungan biopsi cair adalah darah lebih mudah didapat, efektif dan tidak invasif dibandingkan dengan biopsi terutama pada tumor yang sulit dijangkau dengan biopsi. Biopsi cair dapat dilakukan berulang secara serial sehingga dapat digunakan untuk memantau perkembangan penyakit, mengetahui respon pengobatan dan menentukan prognosis.
Tumor Microenvironment in Colorectal Cancer Development: A Review of 3D Study Analysis Angka, Rebecca Noerjani; Sudoyo, Aru Wisaksono; Siregar, Nurjati Chairani; Jeo, Wifanto Saditya; Antarianto, Radiana Dhewayani
Indonesian Journal of Cancer Vol 18, No 1 (2024): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i1.1089

Abstract

Background: Colorectal cancer is the third most common cancer in 2020, with a high mortality rate. Colorectal cancer treatment has made many advances. However, many factors in the tumor microenvironment still have not been reached but significantly affect the success of treatment. This literature review was conducted to search for research articles that analyze factors in the tumor microenvironment, how they interact through studies primarily conducted in 3D, and how to prepare for 3D research on colorectal cancer will be briefly discussed. The aim of this systematic review is to study the components of the tumor microenvironment in colorectal cancer development as assessed by 3D studies. Methods: Article searches were conducted through Embase, Scopus and PubMed. From the 110 articles found at the beginning of the search, after going through several screening stages, 27 articles were determined that met the inclusion criteria. The inclusion criteria used were journals containing research articles on colorectal cancer in the last five years with topics regarding the tumor microenvironment and according to keywords. Results: Microenvironment components in colorectal cancer, consisting of cellular and noncellular components, have the most significant effect on cancer development and ultimately affect metastasis, response to treatment, and prognosis.  Conclusions: This literature review proves that the components of the tumor microenvironment are very diverse, making colorectal cancer heterogeneous. It still requires a lot of research to prove the existence of other components that affect the effectiveness of the treatment.
Co-Authors Abigail Prasetyaningtyas Achmad Fauzi Achmad Fauzi Angka, Rebecca Noerjani Jeo, Wifanto Saditya Lumban Tobing, Demak Nurjati Chairani Siregar Perdana Aditya Rahman Perdana Aditya Rahman Prasetyaningtyas, Abigail Radiana Dhewayani Antarianto