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All Journal Jurnal Ilmu Kedokteran dan Kesehatan CoMPHI Journal : Community Medicine and Public Health of Indonesia Journal
Raharjo, Suryo Wahyu
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Metastasis Kanker Caecum Dari Kanker Rektum Primer : Laporan Kasus Daffa, Kelvin Wilbent; Raharjo, Suryo Wahyu
Jurnal Ilmu Kedokteran dan Kesehatan Vol 12, No 9 (2025): Volume 12 Nomor 9
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v12i9.20173

Abstract

Seorang wanita usia 29 tahun datang dengan diare kronis disertai tinja berdarah. Kolonoskopi dan biopsi mengonfirmasi adenokarsinoma rektum. Pasien menjalani reseksi rektum dengan ileostomi diikuti kemoterapi adjuvan. Pada evaluasi lanjutan ditemukan massa di sekum melalui pencitraan dan kolonoskopi, dan hasil histopatologi menegakkan diagnosis adenokarsinoma metastatik. Pasien kemudian menjalani hemikolektomi kanan serta penutupan stoma. Kanker kolorektal merupakan salah satu keganasan tersering, dengan rektum sebagai lokasi primer yang cukup umum. Metastasis biasanya mengenai organ ekstra-abdomen, sedangkan penyebaran ke segmen kolorektal lain, seperti sekum, sangat jarang. Metastasis kolorektal metakronik didefinisikan sebagai metastasis yang muncul setelah terapi kuratif pada tumor primer. Meskipun metastasis ekstra-abdomen lebih sering pada kanker rektum, metastasis antar-segmen kolorektal merupakan fenomena yang jarang. Kasus ini menekankan pentingnya surveilans komprehensif dengan pencitraan, kolonoskopi, dan penanda tumor untuk mendeteksi pola kekambuhan yang tidak biasa. Kanker kolorektal dapat bermetastasis ke segmen kolon lain, meskipun jarang. Kewaspadaan klinisi saat follow-up penting untuk memungkinkan deteksi dini pola metastasis yang tidak lazim sehingga tata laksana dapat segera diberikan dan hasil klinis lebih baik.
Acute Mesenteric Ischemia in a 68-Year-Old Woman Presenting with Abdominal Pain: A Case Report Hutabarat, Rico Alfredo; Raharjo, Suryo Wahyu
CoMPHI Journal: Community Medicine and Public Health of Indonesia Journal Vol. 6 No. 2 (2025): October
Publisher : Perhimpunan Dokter Kedokteran Komunitas dan Kesehatan Masyarakat Indonesia (PDK3MI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37148/comphijournal.v6i2.289

Abstract

Acute Mesenteric Ischemia (AMI) is a life-threatening condition caused by a sudden reduction in intestinal blood flow, leading to ischemia and potential bowel necrosis. With a mortality rate of 50–80%, delayed diagnosis due to nonspecific symptoms remains a challenge. The primary causes include arterial embolism, thrombosis, non-occlusive mesenteric ischemia (NOMI), and mesenteric venous thrombosis (MVT). Elderly patients, especially those with cardiovascular disease, are at higher risk. Contrast-enhanced CT angiography (CTA) is the gold standard for diagnosis. A 68-year-old woman presented with a three-day history of abdominal pain and was initially diagnosed with acute abdominal pain due to suspected perforated appendicitis. Imaging showed abdomen without pneumoperitoneum, along with chest radiograph found cardiomegaly and aortic elongation. Exploratory laparotomy was performed on February 15, 2025, revealed multiple mesenteric hematomas indicative of AMI and a hyperemic appendix, leading to an appendectomy. Postoperative care included anticoagulation, antibiotics, and supportive therapy. MSCT confirmed mesenteric ischemia with vascular stenosis and thrombi. On February 20, she developed heparin-induced hematochezia, managed with transfusion and hemostatic therapy. The patient remained stable and was discharged on February 24, 2025. This case illustrates the diagnostic challenges of AMI, often misdiagnosed due to its nonspecific symptoms. Exploratory laparotomy played a crucial role in diagnosis, revealing mesenteric hematomas. Contrast-enhanced MSCT confirmed vascular involvement, highlighting the importance of imaging in AMI detection. Anticoagulation was essential for preventing further thrombosis but required careful monitoring due to the risk of bleeding complications. Early recognition and intervention are vital in managing AMI, especially in elderly patients with cardiovascular risk factors. A multidisciplinary approach, including surgical exploration, advanced imaging, and individualized anticoagulation therapy, is crucial for improving outcomes.
Co-Authors Daffa, Kelvin Wilbent Hutabarat, Rico Alfredo