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All Journal Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya Indonesian Journal of Biomedicine and Clinical Sciences
Yuddy Imowanto
Unknown Affiliation
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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OCTREOTIDE FOR TREATMENT RECURRENT HYPOGLYCEMIA INDUCED BY SULFONYLUREA: A CASE REPORT AND LITERATURE REVIEW Yuddy Imowanto; Taufiq Abdullah; Tanjoyo, Hartadi
Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya Vol. 11 No. 3 (2024): Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Univers
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/jkk.v11i3.449

Abstract

Overdose can cause hypoglycemia, which is unresponsive to dextrose treatment alone. Octreotide, though not universally used, is an antidote for sulfonylurea overdose. We present a case report of a 62-year-old male who mistakenly consumed six tablets of sulfonylurea (Glibenclamide®), thinking they were loperamide for diarrhea. He developed dizziness, diaphoresis, vomiting, and unconsciousness. Physical examination revealed a GCS of 225, blood pressure of 188/79 mmHg, heart rate of 85 bpm, respiratory rate of 24/min, and oxygen saturation of 99%. Blood results showed RBS at 13 mg/dl, normal CBC, unremarkable blood gas analysis, hypokalemia at 2.87 mmol/l, and normal RFT and LFT. The patient was treated with bolus Dextrose 40%, maintenance Dextrose 10%, and hydrocortisone 100 mg, but blood sugar remained refractory for 1 hour despite increasing glucose infusion. After 5 hours without satisfactory results, we administered the first dose of octreotide (50 IU IV), resulting in a hypoglycemic interval lasting 2.5 hours. After a second dose of 50 IU octreotide, hypoglycemia was resolved. The patient was moved to the general ward and survived. In this case, octreotide extended the interval of hypoglycemia and reduced the need for dextrose. Using octreotide for conditions other than sulfonylurea overdose is not recommended.
When delays become lethal: A case report of a rare and fatal complication in traumatic carotid cavernous fistula Yuddy Imowanto; Dwiwardoyo Triyuliarto; Putra, Rico Wicaksana; Fatah Abdul Yasir
Indonesian Journal of Biomedicine and Clinical Sciences Vol 57 No 4 (2025)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v57i4.20562

Abstract

Carotid cavernous fistula (CCF) is a rare complication that can be easily missed after blunt traumatic brain injury. It is defined as an abnormal arteriovenous shunt between the carotid artery or its branches with the cavernous sinus. Most cases are traumatic in origin and although not typically life-threatening, carry a risk of serious complications. One of the most fatal complications is spontaneous intracerebral haemorrhage (ICH), occurring only 0.9-2.6% of cases. We report a rare case of a 27 yo female, who sustained traumatic brain and craniofacial injuries in a motor vehicle accident 25 d earlier. She presented with gradual loss of consciousness following ophthalmic symptoms that began 5 d prior to admission. Imaging confirmed the presence of ICH as a complication of traumatic CCF. This case highlights the diagnostic challenges of traumatic CCF and its potential complications. Diagnosis is challenging due to its rare occurrence with variable time interval for symptoms to develop (ranging from several hours to years after the initial injury), non-specific symptoms that may mimic other conditions, and delays in seeking care. Delayed diagnosis can be fatal, leading to visual loss, cerebral infarction, and haemorrhagic events. Rapid recognition and prompt management of traumatic CCF are crucial for preventing complications and achieving complete resolution with low rates of morbidity and mortality.
Co-Authors Dwiwardoyo Triyuliarto Fatah Abdul Yasir Putra, Rico Wicaksana Tanjoyo, Hartadi Taufiq Abdullah