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All Journal The Journal of Society Medicine (JSOCMED) Cermin Dunia Kedokteran
Mirton
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Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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Performed Laparoscopic Surgery For Gastric Perforation: Case Report Mirton; Pasihulilzan; Ashan, Hesty Rhauda
Journal of Society Medicine Vol. 3 No. 6 (2024): June
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i6.147

Abstract

Introduction: Perforated peptic ulcer (PPU) is a life-threatening disease with historically reported high morbidity and mortality rates. The epidemiology of perforated peptic ulcer was appear to be stable in recent. The laparoscopy as primary operation has focused on safety to tread PPU. Case: A 75 years old man presented to our emergency center with generalized abdominal pain since 2 days before admision. Generalize abdominal pain develop suddenly and severe. Patient has history taking NSAID for 7 years to treat pain in the knee joint. He was complaining of chronic and recurrent upper abdominal for 5 year and relieved by food or antacids. He is smoker. After initial resuscitation by adequate administration intravenous lines of fluid and nasogastric tube, Patient underwent a laparocopik surgery, we perform prymari suture and a Graham patch.  We followed administration antibiotic and proton pump inhibitor. We perform the suturing to close the perforation site before peritoneal irrigation to avoid the accumulation of infected fluid and other debris. Once irrigation was complete, a large volume of omentum was reinforced above the primary suture site. Conclusion: We successfully managed perforated peptic ulcers with minimally invasive approach. Adequate resuscitation, hypotension in no longer be a significant prognostic indicator. In experienced hand laparoscopic is probably the most appropriate approach for perforated peptic ulcer. Because no upper abdominal incision is made, there I decreased post operative pain and decrease administration of post operative pain medication. The patient rapidly recovers with less complication.
Giant Phyllodes Tumor of the Breast Silalahi, Fonda R.P; Mirton
Cermin Dunia Kedokteran Vol 50 No 4 (2023): Anak
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v50i4.859

Abstract

Phyllodes tumor is a benign but potentially malignant breast cancer. The incidence phyllodes neoplasm is only about 0.3%-1% of all breast malignancies. A large phyllodes tumor in a 35-year old female was reported. She had history a slowly growing mass in the right breast since 15 years ago and grew rapidly in the last 3 months. After infection control, a right mastectomy with resection of the pectoral muscle was performed followed with secondary closure of the defect with skin graft after 6 weeks. The tumor measured 46x49x24 cm in size and weight of 10.2 kg with malignant histopathological result; no evidence of local or distant recurrence after 3 month follow up.   Tumor phyllodes adalah kelainan payudara yang bersifat jinak, namun berpotensi ganas. Insiden tumor phyllodes sekitar 0,3%-1% dari semua tumor payudara. Dilaporkan kasus pada wanita berusia 35 tahun dengan tumor phyllodes yang berukuran sangat besar. Massa payudara kanan berukuran kecil yang tumbuh perlahan telah ada sejak 15 tahun. Dalam 3 bulan terakhir terjadi pertumbuhan massa yang cepat dan progresif. Setelah pengendalian infeksi, dilakukan mastektomi kanan dengan reseksi otot pektoralis. Selanjutnya dilakukan perawatan luka sekunder dan diikuti dengan penutupan defek dengan tandur kulit setelah 6 minggu. Didapatkan tumor berukuran 46x49x24 cm dan berat 10,2 kg dengan hasil histopatologi keganasan. Tidak ada bukti kekambuhan lokal atau jauh setelah 3 bulan tindak lanjut. Fonda RP Silalahi, Mirton. Tumor Phyllodes Payudara.
Co-Authors Ashan, Hesty Rhauda Pasihulilzan Silalahi, Fonda R.P